Date of Award


Document Type

Independent Study

Degree Name

Master of Science (MS)


Depression is one of the most prevalent disabling diseases affecting millions of people around the world. Many depressed individuals also suffer from co-morbid conditions that complicate treatment of their depression. Joe is a 65 year old male being seen for fatigue and a PHQ-9 score of 10. Initiation of treatment for depression was commenced with the serotonin reuptake inhibitor, sertraline. Selective serotonin reuptake inhibitors (SSRis) are first line medications for the treatment of depression. Pharmacological and clinical studies have identified slight differences in the profile of each SSRI, giving them unique advantages for use in comorbid conditions such as anxiety, obsessive compulsive disorder, obesity, insomnia, and cognitive deficits. Many of the SSRis have been found to be equally efficacious in the treatment of conditions, or conflicting results cannot discern an advantage of one SSRI over another. Sertraline has been found to be the most cost-effective SSRI in the treatment of depression, while escitalopram is the SSRI to be the best tolerated with the least likelihood of causing drug-drug interactions. Choosing the appropriate SSRI for the treatment of depression while considering co-morbid conditions can improve overall outcomes and compliance with the treatment plan