Match the following patient clinical profiles with the most appropriate next step in management.
- 70-year-old man, 3 weeks post-myocardial infarction, meeting criteria for major depressive disorder.Initiate sertraline
- 28-year-old woman in her first trimester of pregnancy with psychotic depression and refusal of oral intake.Schedule urgent electroconvulsive therapy
- 40-year-old man with major depressive disorder, experiencing persistent sexual dysfunction and fatigue on an SSRI.Augment with bupropion
- 25-year-old woman with major depressive disorder characterized by prominent insomnia and significant weight loss.Initiate mirtazapine
- 22-year-old man with severe depression and a history of a 7-day period of euphoric mood, grandiosity, and decreased need for sleep.Initiate quetiapine
Answer
The most appropriate management strategies are matched as follows: the post-myocardial infarction patient with sertraline, the pregnant patient with psychotic depression with urgent electroconvulsive therapy, the patient with SSRI-induced sexual dysfunction with bupropion augmentation, the patient with insomnia and weight loss with mirtazapine, and the patient with a history of mania with quetiapine.
The correct matches align specific interventions with the unique clinical presentations of each patient, ensuring efficacy while minimizing risks and addressing prominent side effects or symptoms.
Step-by-Step Solution
Key Concept
Tailoring the pharmacological and procedural management of depressive disorders requires careful consideration of medical comorbidities, prominent symptom profiles, clinical acuity, and past psychiatric history.
Estimated Time:1m 30s