Thanks to Dr Goel for the answers on this one. Depressingly for your forthcoming PSA there is rarely a single correct answer to any question in medicine but a selection of alternatives that might be used for different patients.....sorry (MC)
Diagnosis: depression/post-stroke depression
Treatment options include:
SSRIs (fluoxetine 20mg od, sertraline 50mg od) – you might want to think about increased incidence of bleeding with SSRIs. If you were thinking about citalopram then you might want to think about the associated QTc prolongation which, in this cohort of patients, is important to consider, especially if they are on cardiac or other meds causing QTc prolongation (major tranquilizers or some antibiotics for example).
Other Rx such as mirtazapine (15mg nocte) is also sensible – which would avoid the issues above and might have the additional effect that appetite might be positively stimulated.
In order to get some prescribing resources out there we intend to publish a series of prescribing problems on the website. The problems will appear at least weekly with the "answers" appearing a couple of days later. We'll use the standard exam stationery available on the LSE, but also available below in case you haven't got access to the LSE.