A 63-year-old female patient with a history of generalized a…
Questions
A 63-yeаr-оld femаle pаtient with a histоry оf generalized anxiety disorder (GAD) and chronic kidney disease (CKD stage 3) presents for follow-up. She reports worsening anxiety, restlessness, and insomnia. She previously responded well to paroxetine but stopped it due to weight gain and constipation. She has tried alprazolam intermittently but prefers a long-term, non-sedating option. Her current medications include: Metoprolol 25 mg BID Lisinopril 10 mg daily Calcium carbonate 500 mg BID Vitamin D3 1000 IU daily Her GFR is 42 mL/min/1.73m². She denies suicidal ideation or substance use. As her PMHNP, which of the following is the most appropriate pharmacologic option at this time?
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