Minimal Infant Exposure in Medicine / Internal Medicine — 28yo Woman | Psychiatry | SMLE Q#5120
SMLE Question #5120
Medicine / Internal Medicine
Psychiatry
Objective: OBJ-253
Last updated: February 2026
A 28-year-old woman, G1P1, presents 4 weeks after an uncomplicated vaginal delivery. For 3 weeks, she has had persistent low mood, anhedonia, frequent crying, poor sleep despite exhaustion, and excessive guilt. Symptoms occur most days, are worsening, and impair daily functioning. She denies suicidal ideation, hallucinations, or delusions. She is exclusively breastfeeding and wants treatment with minimal infant exposure. Mental status exam shows a tearful, cooperative, fully oriented woman without psychotic features. What is the most appropriate pharmacologic management?
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