4th May 2024

A 48-year-old woman presents to the general practice clinic with a six-month history of persistent sadness, fatigue, and a lack of interest in daily activities.

A 48-year-old woman presents to the general practice clinic with a six-month history of persistent sadness, fatigue, and a lack of interest in daily activities. She reports difficulty concentrating at work and a significant decrease in her social interactions. She mentions her appetite has decreased, leading to unintentional weight loss. The patient has a history of hypertension and is currently on medication. There is no history of substance abuse, and she denies any suicidal ideation.

What is the single most appropriate initial pharmacological treatment?