A 30-Year-Old Man Comes to the Office Due to Depression

A 30-year-old man comes to the office due to depression.  He describes a 4-week history of severely depressed mood, loss of motivation, loss of interest, and sleeping 12 hours a day.  The patient has difficulty concentrating and worries that it is interfering with his work.  He is pessimistic about the future but has no suicidal thoughts.  The patient had a previous depressive episode in his 20s that responded rapidly to sertraline.  He felt "really good and energetic" after a few days of treatment but discontinued the antidepressant a week later as he did not feel that he needed it.  He drinks 1 or 2 beers on social occasions.  Physical examination is normal.  Which of the following would be most important to assess prior to initiating pharmacologic treatment for this patient?

A) Complete blood count
B) Comprehensive metabolic panel
C) Electrocardiogram
D) History of mania
E) History of sexual dysfunction
F) Urine toxicology

Correct Answer:

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