Vignette: A 35-year-old woman presents to the clinic with symptoms of depression. She describes feelings of sadness, loss of interest in activities she previously enjoyed, and difficulty sleeping. She also reports unintentional weight loss. After a thorough evaluation, her physician prescribes her a medication. Two weeks later, the patient returns to the clinic complaining of a dry mouth, constipation, and blurred vision. The physician tells her that these are side effects of the medication she was prescribed.
The question: Which of the following medications was most likely prescribed to this patient?
This patient was likely prescribed a tricyclic antidepressant (TCA), such as Imipramine, given the side effects she is experiencing. TCAs work by inhibiting the reuptake of norepinephrine and serotonin in the brain, increasing their concentrations and thus improving mood. They are not first-line treatments for depression due to their side effect profile, but can be used when other treatments fail. The side effects experienced by the patient, which include dry mouth, constipation, and blurred vision, are due to the anticholinergic effects of TCAs. Other potential side effects include urinary retention and confusion, particularly in older adults. The other options listed (Fluoxetine, Bupropion, Venlafaxine, and Sertraline) are other types of antidepressants that have different side effect profiles and are less likely to cause anticholinergic effects.