Alejandro is a 34 y/o Hispanic male, civil engineer. He was brought in by his wife because he has suffered from depressive symptoms
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Alejandro is a 34 y/o Hispanic male, civil engineer. He was brought in by his wife because he has suffered from depressive symptoms for the past month including disrupted sleep, loss of appetite, feelings of worthlessness, and wanting to die but not suicidal. He is admits to having suffered an episode of this in high school. He is diagnosed with DSM-5 Major Depressive Disorder, recurrent, moderate. He was started on Prozac 20mg once daily. He was also supposed to start psychotherapy. He stated at that time that he did had a hunting rifle in his home and that he should have it removed and not have any access to weapons.
Alejandro returns to see you two weeks later. He says that he is still feeling sad, has decreased motivation, and feels that things are getting worse.
What additional questions do you have now?
Has your diagnosis changed? Please articulate your rationale.
What medication(s) would you recommend and why?
Identify one research or evidence-based practice article to support your responses and include the citation (with a link if available).