A 38-year-old woman has 8 weeks of low mood, anhedonia, early-morning awakening, low energy, and guilt. She denies mania, psychosis, substance use,

Question

A 38-year-old woman has 8 weeks of low mood, anhedonia, early-morning awakening, low energy, and guilt. She denies mania, psychosis, substance use, and suicidal intent. TSH and CBC are normal. Which of the following is the most appropriate next step in management?

Accepted Answer

Begin an SSRI and arrange follow-up in several weeks

Answer

Begin lithium as first-line monotherapy

Answer

Prescribe alprazolam as long-term treatment

Answer

Recommend electroconvulsive therapy as initial care

Answer

Delay treatment until symptoms persist for 1 year

Major depressive disorder — USMLE Step 3 MCQ

A 38-year-old woman has 8 weeks of low mood, anhedonia, early-morning awakening, low energy, and guilt. She denies mania, psychosis, substance use, and suicidal intent. TSH and CBC are normal. Which of the following is the most appropriate next step in management?