Antidepressant of Choice with Treatment-Resistant Hypertension?

Clinical Case Discussion: Antidepressant of Choice with Treatment-Resistant Hypertension?

[NEW UPDATE: CLINICAL CASE DISCUSSIONS]:

In our Clinical Case Discussions section: Dr. Satinderpal Kaur (Family Medicine) & Dr. Harvinder Singh (Psychiatry) will discuss clinical cases to integrate the clinical cases from Psychiatry and Medicine.

This is a case of a female patient in her 50s presenting with a worsening major depressive episode with multiple comorbid medication conditions including treatment-resistant hypertension. She is on the following medications for medical conditions:

  • Metformin 500 mg twice daily
  • Jardiance 25 mg daily
  • Mounjaro 10 mg Q7 days
  • Long-acting Insulin Lantus 20U at bedtime
  • Losartan 50 mg daily
  • Spironolactone 50 mg daily
  • Metoprolol 100 mg daily
  • Rosuvastatin 20 mg daily
  • Pregabalin 150 mg twice daily
  • Tramadol 50 mg as needed for pain
  • Levothyroxine 150 mcg daily

Patient has failed the trial of duloxetine (liver enzyme elevation) and bupropion (worsening of anxiety).

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