Review Question - QID 109757

A 27-year-old woman presents to her primary care physician’s office with fatigue, headaches, and concentration difficulties. Her symptoms began approximately 7 months prior to presentation. Throughout this time, she reports problems with falling and remaining asleep, has noticed periods of muscle soreness, and has feelings of restlessness. She is very concerned about whether she will be able to pay her monthly expenses and if her parents are satisfied with her career choices. She is also worried about how her colleagues and supervisor think of her. She denies any significant medical history besides occasional palpitations. She takes a daily multivitamin. Family history is significant for panic disorder in her mother. She currently lives alone and at times socializes with friends. She occasionally drinks alcohol during social gatherings, does not smoke, and denies any illicit drug use. Her temperature is 99°F (37.2 °C), blood pressure is 110/75, pulse is 101/min, and respirations are 18/min. Physical examination is unremarkable. Which of the following is the most appropriate pharmacologic treatment for this patient?