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Stephanie is a 36-year-old female who presents to the clinic with a...

Stephanie is a 36-year-old female who presents to the clinic with a history of anxiety. Social history is unremarkable. For the last 4 years, she has been well controlled on paroxetine, however she feels "it just doesn't work anymore." You have decided to change her medication regimen to vortioxetine 5mg, titrating up to a max dose of 20mg per day based on tolerability. The patient asks, "When can I expect this to start kicking in?" The best response is:

a. 3 or 4 days

b. 1 or 2 weeks

c. 3 or 4 weeks

d. 10 weeks


Amber is a 26-year-old female who presents to the clinic 6 weeks postpartum. The patient states that she has been "feeling down" since the birth of her son. She is currently breastfeeding her infant. You diagnose the patient with Postpartum depression. Which of the following is the LEAST appropriate option in treating her PPD?

a. paroxetine

b. escitalopram

c. citalopram

d. sertraline


Rebecca is a 32-year-old female who was recently prescribed escitalopram for MDD. She presents to the clinic today complaining of diaphoresis, tachycardia, and confusion. The differential diagnosis for this patient, based on the symptoms presenting, is:

a. Panic disorder

b. Gastroenteritis

c. Abnormal gait

d. Serotonin syndrome


Earle is an 86-year-old patient who presents to the hospital with a Community Acquired Pneumonia. During stay, you notice that the patient often seems agitated. He suffers from cognitive decline and currently takes no mental health medications. Treatment for the CAP include ceftriaxone and azithromycin. The LEAST appropriate medication to treat Earle's anxiety is:

a. sertraline

b. duloxetine

c. citalopram

d. venlafaxine


Cindy is a 55-year-old patient who presents with symptoms consistent with Generalized anxiety disorder. The patient has an unremarkable social history other than she consumes two or three glasses of wine per night. Which of the following would be an appropriate therapy to start this patient on?

a. Xanax 0.25mg BID PRN Anxiety

b. Escitalopram 10mg daily

c. Buspirone 10mg BID

d. Aripiprazole 10mg daily

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