Review Question - QID 213648

A 26-year-old man presents to a psychiatrist with low energy and depressed mood for the past month. He also reports poor sleep and no longer enjoys his usual activities. He sometimes feels hopeless and wonders if he would be better off dead. He denies any depressive episodes in the past or any lifetime history of drug or alcohol use. In college, he experienced frequent anxiety prior to exams. He was once hospitalized for erratic behavior (including public nudity and throwing his possessions into the street), recalls seeing "spirits," and being unable to sleep for over a week at that time. He says that he has avoided psychiatric medications in the past, but wants to start one now and asks his psychiatrist what they would recommend. Which of the following would be most appropriate monotherapy for treating this patient's mood symptoms and decreasing his suicide risk?