AKT-1759

AKT-1759

A 50-year-old woman has metastatic breast cancer in her bones. Pain has been well controlled with modified-release morphine and she is still quite mobile. A palliative care nurse has given her a National Comprehensive Cancer Network (NCCN) Distress Thermometer for Patients. This is a visual analogue scale that records subjective distress on a scale of 0-10. She records 7-8 and most of this is recorded as being due to emotional issues (depression, nervousness, worry, loss of interest). She is assessed to have moderate depression with significant functional impairment. She declines psychological intervention, but would be happy to take medication.
Which of the following is the most appropriate medication?