Q:

A 64-year-old man has recently suffered from an MI and is on aspirin, atorvastatin and ramipril. tired easily and can’t concentrate on anything. What is the most appropriate treatment?

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A 64-year-old man has recently suffered from an MI and is on aspirin, atorvastatin and ramipril.

He has been having trouble sleeping and has been losing weight for the past 4 months. He

doesn’t feel like doing anything he used to enjoy and has stopped socializing. He says he gets

tired easily and can’t concentrate on anything. What is the most appropriate treatment?


  1. Lofepramine
  2. Dosulepin
  3. Citalopram
  4. Fluoxetine
  5. Phenelzine

All Answers

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The key is C. Citalopram. [Among SSRIs Sertraline is the drug of choice for ischemic heart disease.

Next choice is citalopram (as it is often related to torsades de pointes it is not 1st choice). If SSRI cannot

be used Mirtazapine is recommended as next antidepressant].

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