hardcardiacpost-MI depressionsertralineSADHARTQTc prolongation
A 67-year-old male with a recent history of myocardial infarction 8 weeks ago presents for psychiatric evaluation. He reports persistent sadness, loss of interest in activities, poor sleep, low energy, and feelings of worthlessness for the past 6 weeks. His PHQ-9 score is 19. His current cardiac medications include aspirin, metoprolol, atorvastatin, and lisinopril. His most recent ECG shows a QTc interval of 448 ms. He has no prior psychiatric history and no known drug allergies. The PMHNP determines that pharmacotherapy for depression is indicated. Which medication plan is most appropriate?