15th February 2025

A 50-year-old gentleman asks you for a medical review.

A 50-year-old gentleman asks you for a medical review. He has a long history of mild personality disorder and borderline pattern. He has managed his condition successfully so far with counselling. However, over the last 3 months, he has felt increasingly worthless and low in mood. He has lost interest in almost all activities, is sleeping poorly, is unable to go to work, and has repeating thoughts of suicide. Today, he expresses ongoing low mood with suicidal ideation and appears severely depressed with flat affect, difficulty concentrating, poor eye contact and slow speech. He has started a course of talking therapy but remains very low and, as a result, asks you if there is any drug treatment he could trial. Which of the following medications might you consider?

Select the SINGLE most appropriate option from the list below. Select ONE option only.