Soru

During a routine primary care visit, a 31-year-old architect describes feeling 'drained of all energy' for the past month. She reports sleeping up to 13 hours daily, a 4-kg (8.8-lb) weight gain, and profound sadness. She states, 'I cannot concentrate on my blueprints anymore.' The patient has no prior medical conditions and takes no daily medications. Upon further questioning, she recalls a period in her early 20s when she felt 'on top of the world' for about a week. During that time, she slept only 2 hours a night, spent her entire savings on luxury clothes, and felt her thoughts were racing, which ultimately led to a brief inpatient admission. Currently, she appears lethargic and speaks with a flat affect. She reports that for the past 2 days, she has occasionally heard a voice calling her name when she is alone in her apartment. Laboratory studies show a TSH of $1.5 \mu U/mL$ (normal: $0.5-5.0 \mu U/mL$) and free T4 of $1.2 ng/dL$ (normal: $0.9-1.7 ng/dL$). Which of the following is the most appropriate next step in pharmacologic management?