A 45-year-old male presents with persistent low mood, fatigu…

A 45-year-old male presents with persistent low mood, fatigue, and difficulty concentrating for the past 3 months. He reports chronic lower back pain and frequent headaches that interfere with his daily functioning. He denies suicidal ideation. He has tried cognitive-behavioral therapy with minimal improvement. Medical history includes mild hypertension, well-controlled on lisinopril. He does not use alcohol or illicit drugs. On mental status exam, he appears tired, with slowed speech and psychomotor retardation. Thought process is logical, and there are no hallucinations or delusions. Which class of medication would be the most appropriate first-line choice for this patient? 

A 24-year-old male college student is brought to the emergen…

A 24-year-old male college student is brought to the emergency department by his parents due to bizarre behavior and social withdrawal. Over the past 6 months, he has become increasingly isolated, stopped attending classes, and spends most of his time in his room. His parents report that he talks to himself and sometimes laughs for no apparent reason.On interview, he appears disheveled and avoids eye contact. He reports hearing voices that comment on his actions and believes his professors are sending him secret messages through emails. He speaks in a disorganized manner and often gives irrelevant answers. He shows little emotional expression and has difficulty initiating conversation. Which class of medication is the most appropriate first-line treatment for this patient? 

A 42-year-old female with major depressive disorder is start…

A 42-year-old female with major depressive disorder is started on sertraline 50 mg daily. After one week, she develops severe hepatotoxicity, confirmed by markedly elevated liver enzymes on lab testing. She denies alcohol use, acetaminophen use, or any other medications. There is no prior history of liver disease. The reaction is unexpected given the usual safety profile of SSRIs. This is an example of a(n):