Question

A taxi driver has been diagnosed with GAD. He is unwilling to take antidepressants due to his previous sexual dysfunction and cannot take any sedating medication because of his job. What medication would you offer next?

1) Venlafaxine
2) Imipramine
3) Clomipramine
4) Clonazepam
5) Mirtazipine
6) Moclobemide
7) Olanzapine
8) Clozapine

Answer 1

The appropriate medication option for a taxi driver with GAD who avoids antidepressant-induced sexual dysfunction and sedating medication is venlafaxine, as it does not generally cause sedation or significant sexual side effects.

Step-by-step explanation:

The suitable medication for a taxi driver diagnosed with Generalized Anxiety Disorder (GAD) who cannot take antidepressants due to sexual dysfunction and needs to avoid sedating medications for work would be venlafaxine. Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that can treat anxiety without the sedative effects that could impair the driver's ability to operate a vehicle. It generally has fewer sexual side effects than some SSRIs and SNRIs. Other options such as imipramine, clomipramine, and mirtazapine may cause sedation or have a known side effect profile that includes sexual dysfunction, whereas benzodiazepines like clonazepam are sedating. Antipsychotics like olanzapine and clozapine are not typically used as first-line treatments for anxiety and can be sedating. Moclobemide, a reversible inhibitor of monoamine oxidase A (RIMA), could be considered but is not among the typical first-line treatments for GAD.