Match each patient's clinical presentation of major depressive disorder with the most appropriate initial pharmacological treatment based on their specific comorbidities and symptom profiles.
- A 45-year-old patient with major depressive disorder and poorly controlled diabetic peripheral neuropathy.Duloxetine
- A 28-year-old patient with major depressive disorder who strongly wishes to avoid sexual dysfunction and weight gain.Bupropion
- A 78-year-old patient with major depressive disorder presenting with severe insomnia and a 10-lb weight loss over the past month.Mirtazapine
- A 60-year-old patient with major depressive disorder who was hospitalized for a myocardial infarction two weeks ago.Sertraline
Answer
The correct matches link the patient with diabetic neuropathy to Duloxetine; the patient avoiding sexual dysfunction and weight gain to Bupropion; the patient with insomnia and weight loss to Mirtazapine; and the patient with a recent myocardial infarction to Sertraline.
The correct pairings rely on matching the known side effects and secondary indications of antidepressants with specific patient needs. Duloxetine treats neuropathy; bupropion avoids sexual dysfunction; mirtazapine promotes sleep and appetite; and sertraline is safe post-myocardial infarction.
Step-by-Step Solution
Key Concept
Selecting the most appropriate antidepressant based on side-effect profiles and patient comorbidities.