AKT-4227
A 65-year-old lady who you have looked after during her recent breast cancer diagnosis and treatment comes to see you one year after undergoing a total mastectomy followed by chemotherapy and radiotherapy.
Her disease is now in remission and she is taking tamoxifen. She has a history of a perforated duodenal ulcer and has had bouts of paroxysmal atrial fibrillation. She complains of feeling very tearful and low in mood, and feels traumatised by her experiences. She is also having some chest wall neuropathic type pain, probably due to the radiotherapy. A PHQ9 depression questionnaire confirms that she is suffering from moderately severe depression.
Which of the following would be most appropriate to treat her?