A 76 year-old male comes to your office to discuss his ongoing medical problems. He reports feelings of sadness and hopelessness. He was fired from his job due to his angry outbursts and for showing frustration even over small matters. He has lost interest in watching football, which he used to enjoy a lot. He has difficulty sleeping. He feels a lack of energy even to do small tasks like waking up from his bed. His appetite has never been this low in ‘his entire life’. He was diagnosed with HIV over a decade ago. He can’t stop blaming himself because his life was lost over a one-night stand sexual encounter and he was diagnosed with a deadly disease. Sometimes he entertains thoughts of suicide but they are mostly under control now. He had taken sertraline 50 mg daily for a few months but in his words, ‘it didn’t do a thing for me’. His vital signs are normal. Physical examination is significant for a tearful patient, who looks sad and emaciated. Which of the following medications is the best choice to treat his symptoms?
