Rosh Psychiatry Board Practice Exam

Which antidepressant is appropriate for treating depression in a patient with recent onset symptoms?

1. Amitriptyline

2. Bupropion

3. Sertraline

4. Tranylcypromine

The correct answer is: Sertraline

Selecting sertraline for treating recent onset depression symptoms is supported by its efficacy as a first-line treatment for major depressive disorder. Sertraline is a selective serotonin reuptake inhibitor (SSRI), which is well-tolerated and effective in alleviating depressive symptoms. It is particularly suitable for patients experiencing moderate to severe depression, as SSRIs have a favorable safety profile and a lower risk of side effects compared to older classes of antidepressants, such as tricyclic antidepressants, which can be more dangerous in overdose scenarios and may cause more adverse effects. Given its rapid onset of action, sertraline is beneficial for those new to treatment, as it can start to improve symptoms within a few weeks of initiating therapy. In contrast, options like amitriptyline, a tricyclic antidepressant, may have more significant side effects and risks, especially in individuals with certain comorbid conditions. Bupropion, while effective, is typically not the first choice for initial treatment of depression due to contraindications in certain populations, particularly those with anxiety. Tranylcypromine, a monoamine oxidase inhibitor, is generally reserved for treatment-resistant depression and requires dietary restrictions, making it less appropriate for first-line treatment