| Original Message |
Anonymous (no login)
Posted Feb 12, 2008 3:33 AM
A 42-year old Caucasian man comes to the office for follow-up. He was diagnosed with depression two months ago, and has been undergoing treatment with fluoxetine ever since. The patient states that he is feeling better, and his sleep has improved. He is more optimistic, but he is worried because he is losing weight. His appetite continues to decrease despite treatment. He does not smoke or use illicit drugs, but he drinks alcohol on weekends. He works as a sales representative. Examination reveals no abnormalities. The patient is 5’11" tall, and weights 156 pounds. He lost 12 pounds in the last four months. Which of the following will be the most appropriate next step in the management of this patient?
A) Refer the patient to the nutritionist.
B) Start a work-up to rule out malignancy.
C) Stop fluoxetine; start bupropion.
D) Stop fluoxetine; start mirtazapine.
E) Continue fluoxetine; observe and reevaluate in one month.
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