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Answer :
Final Answer:
The appropriate first-line medication for Gary, a 26-year-old graduate student diagnosed with major depressive disorder (MDD) without psychotic features who declines psychotherapy, is Sertraline (Zoloft®).
Explanation:
In choosing an appropriate first-line medication for Gary, several factors need consideration.
Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for depression and anxiety disorders.
It is often preferred in cases like Gary's due to its favorable side effect profile and lower risk of overdose compared to tricyclic antidepressants (TCAs), such as Amitriptyline.
Bupropion, another option, is an atypical antidepressant that works on norepinephrine and dopamine.
It may be considered for individuals concerned about sexual side effects commonly associated with SSRIs.
However, given Gary's diagnosis and preferences, SSRIs are generally the first-line treatment.
Amitriptyline, a tricyclic antidepressant, and Trazodone, a serotonin antagonist and reuptake inhibitor (SARI), are less commonly used as first-line treatments due to their side effect profiles and potential risks, especially in younger populations.
The decision to prescribe medication should always involve a thorough evaluation by a healthcare professional, considering the individual's medical history, potential side effects, and personal preferences.
While medication can be a valuable component of treatment for depression, it is crucial to monitor its efficacy and adjust the treatment plan accordingly.
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