A 72 year-old man is brought to your office by his daughter for evaluation. For the last 3 months, he has been suffering from difficulty falling and staying asleep, severe fatigue, poor appetite, and fatigue. He lost interest in the activities he used to enjoy such as fishing and spending time in the local library. He forces himself to go to the library a few times a week but he lost interest in reading the newspaper and watching television which he used to enjoy until recently. He feels like he has little energy and thinks he is a burden to his daughter’s family. His last hospitalization was four months ago for myocardial infarction. He denies any chest pain, palpitations or shortness of breath. He takes metoprolol 25 mg once daily and hydrochlorothiazide 25 mg once daily. He lost his beloved wife to cancer three years ago. His daughter says, ‘his grandkids love him. There is no reason for him to feel lonely’. Recently, he is having problems remembering details. His vital signs are normal. His physical examination is unremarkable. What is the next best step in the management of this patient?
