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June poll results.

Ms. H, age 33, has completed a course of cognitive-behavioral therapy (CBT) for major depressive disorder (MDD) and is continuing to take sertraline, 50 mg/d. During treatment, Ms. H reported improved mood and quality of life and increased productivity at work. Two months later, Ms. H reports that she is exhausted and unmotivated to go to work, and has started to withdraw socially. Ms. H says that no matter how much sleep she gets, she does not want to get out of bed in the morning and has called in sick to work for several days in a row. She scores high on the Fatigue Associated with Depression Questionnaire. What treatment would you choose for Ms. H?

37% Stop sertraline and start bupropion, titrated to 450 mg/d

39% Continue sertraline, begin another course of CBT, and encourage Ms. H to exercise

7% Stop sertraline, and switch to escitalopram, 20mg/d

17% Stop sertraline and start modafinil, 200 mg/d, and encourage Ms. H to start exercising for 30 minutes daily

SUGGESTED READING: Sohail Z, Macaluso M. Current Psychiatry. 2015; 14(6):16,17,28-32.

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Publication:Current Psychiatry
Article Type:Report
Date:Aug 1, 2015
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