🏥 USMLE Exam Prep

A 25-year-old woman with a history of major depressive disorder has been taking fluoxetine 20 mg daily for 2 weeks. She reports feeling more anxious, restless, and has difficulty sleeping since starting the medication. Her depression symptoms have not yet improved. Which of the following is the most appropriate next step in management?

A Discontinue fluoxetine and start a tricyclic antidepressant
B Increase the dose of fluoxetine to 40 mg daily
C Prescribe a short course of a benzodiazepine
D Switch to a monoamine oxidase inhibitor (MAOI)

✓ Correct Answer: Option C

Initial SSRI treatment can cause transient side effects like increased anxiety, restlessness, and insomnia before therapeutic benefits emerge. A short course of a benzodiazepine can help manage these acute symptoms while continuing the antidepressant.

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