USMLE Forum - Largest USMLE Community

A 57 yr old woman comes to physician because of difficulty sleeping, tearfulness and restlessness since her daughter was diagnosed with metastatic breast cancer 3 days ago . she reports that when she goes to bed at night, she unable to fall asleep for several hours and lays in bed worrying about her daughter’s situation. The pt underwent a mastectomy for breast cancer 7 yrs ago.she takes acetaminophen/butalbital for occasional migraines. Her vitals are normal. P/E-NAD. Mental status-tearful, tense but calms during the conversation. No evidence of suicidal ideation. Which is most appropriate next step in Mx?
A. Biofeedback
B. Carbamazepine therapy
C. Clonazepam
D. Clonidine
E. Imipramine
F. Olanzapine
G. Pentobarbital therapy
H. Sertraline.

CC

@medplus, why clonidine?

@medplus
sorry, my mistake...u mention clonazepam
why clonazepam?

why not SSRI Sertraline?

My problem is,i cant even,diagnose her problem?
psycho makes me carzy.

H -> depression. She hits like 4 or 5 of the SIGECAPS for depression and has problem before

Her problems start 3 days ago(less than 2 weeks)???

we can wait more 2 weeks )))))really i don't know!I just know in America MC Tx of depression use SSRIs

anxiety....acute satge...C

antidepreesants take time to be effctive