Review Question - QID 216696

A 54-year-old man presents to his primary care physician for poor sleep. For the last 3 months, he has had difficulty falling asleep due to worrying about life stressors. He also notes that his concentration and motivation have been poor at work, and he is worried about getting fired. He becomes tearful as he describes feeling guilty for not being a good husband to his wife. He also reports that his wife has been frustrated with him for no longer wanting to go hiking, an activity they used to enjoy together. He requests medication for sleep, stating "If I could just get some sleep, maybe things would be back in order for me." On review of systems, he endorses chest palpitations and premature ejaculation. He has a medical history of hypertension, hyperlipidemia, and paroxysmal atrial fibrillation. His temperature is 99°F (37.2°C), blood pressure is 130/80 mmHg, pulse is 84/min, respirations are 15/min, and oxygen saturation is 98% on room air. Physical exam reveals a calm man. He walks with a steady gait and his neurological exam is nonfocal. His affect appears depressed. Which of the following medications would be most appropriate for this patient?