A 22-Year-Old Man Comes to the Office Due to Difficulty

A 22-year-old man comes to the office due to difficulty concentrating and sleeping.  The patient lost his job and moved in with his parents 2 months ago.  Although he has been looking for work and revising his resume, he gets distracted and easily loses focus.  The patient has not received any interview invitations and is worried that he will be living with his parents for a long time.  He feels that he has "reverted to my high school self," playing video games most evenings and going out with friends on the weekends.  The patient gets annoyed with his parents occasionally but states that he knows they are "just trying to be helpful."  He has been eating more than usual since moving, gaining 3 kg (6.6 lb) and feeling tired during the day.  The patient takes 2-3 hours to fall asleep each night and frequently checks the time while in bed.  He drinks 3 or 4 beers a week and does not use recreational substances.  Vital signs are within normal limits.  Physical examination shows no abnormalities.  The patient states that his mood is "okay," and he has a full range of affect.  He reports no suicidal ideation.  In addition to recommending psychotherapy, which of the following is the most appropriate pharmacotherapy for this patient?

A) Alprazolam
B) Lithium
C) Methylphenidate
D) Quetiapine
E) Zolpidem

Correct Answer:

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