January 2014

A 59-year-old woman presented to clinic for evaluation of multiple moles. Although the moles were not suspicious on physical exam, she was noted to have bilateral deformities of her thumb nails. Her past medical history is significant for chronic knee pain and breast cancer that was successfully treated 13 years ago. What is your diagnosis?

Several factors should be considered when choosing a medication and dosing schedule for this depressed adult male who reports being "very sensitive" to medication and expresses particular concern about being either sedated or "revved up" from an antidepressant.