136) A 55-year-old man with history of depression has recently been started on fluoxetine. The patient has history of severe depression in the past. Fluoxetine dose has been recently increased to obtain adequate control of his symptoms. His depression symptoms are well-controlled now but the patient now complains of erectile dysfunction. He is deeply concerned about this since this problem is adversely affecting his relations with his wife. Which of the following is most appropriate next step in managing this patient’s symptoms?
A) Decrease the dose of Fluoxetine
B) Start Sildenafil
C) Discontinue Fluoxetine and switch to Bupropion
D) Recommend Yohimbine
E) Recommend penile vacuum pump device.
b
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c
Answer C
Nice little table to remember for exam:
1) Depression + Stop smoking + No weight gain + No sexual side effects = Buprapion
2) Depression + Neuropathic pain = Duloxetine
3) Depression + Insomnia= Trazadone (pt. is gone–sleep)
4) Depression + anxiety= Prozac (fluoxetine)