Question

A 55-year-old man with long-standing type 2 diabetes presents with low mood, anhedonia, insomnia and reduced appetite for 2 months. He denies active suicidal intent. Physical examination is unremarkable. What is the most appropriate initial management in primary care?

Accepted Answer

Offer a selective serotonin reuptake inhibitor (e.g. Sertraline) plus psychological intervention such as cognitive behavioural therapy

Answer

Watchful waiting with no active treatment

Answer

Offer guided self-help only

Answer

Prescribe a tricyclic antidepressant as first-line

Answer

Refer as an emergency to the crisis team

Practice question

A 55-year-old man with long-standing type 2 diabetes presents with low mood, anhedonia, insomnia and reduced appetite for 2 months. He denies active suicidal intent. Physical examination is unremarkable. What is the most appropriate initial management in primary care?