138) A 25-year-old woman is diagnosed with major depression. She denies any suicidal ideation. She has no history of manic episodes. She smokes about 1 pack of cigarettes per day. The patient has been appropriately counselled on smoking cessation and is offered antidepressant therapy. She agrees to antidepressant therapy. The patient is very particular about her weight and would never consider any therapy that would lead to weight gain. Which of the following is the most appropriate next step?
A) Start Mirtazepine
B) Start Fluoxetine
C) Start Venlafaxine
D) Start Bupropion
E) Psychotherapy alone
Q139) After one week of beginning the therapy, the patient calls you and reports no improvement in her symptoms. She has been using the therapy regularly. She is upset and would like to discontinue the therapy. Which of the following is most appropriate response?
A) “The Medication is not working. I can switch you to a different therapy”
B) “I am concerned about your compliance with the medications”
C) “You will need group therapy”
D) “You will need Electro-convulsive therapy”
E) “There may be a lag of two to six weeks before the therapy works”
Filed under: USMLE Test Prep | Tagged: Antidepressant, Major depressive disorder, USMLE Step 3 psychiatry | 7 Comments »
Archer USMLE Step 3 Blog 