Grief and Bereavement
A previously well woman cannot sleep and cries frequently for 5 days after her sibling died suddenly. She has no other depressive features and was functioning well before the loss. Along with supportive psychotherapy, which is the most appropriate short-term pharmacologic option?
- A.LorazepamCorrect
- B.Fluoxetine
- C.Imipramine
- D.Chlorpromazine
Explanation
This is an acute grief reaction with a prominent short-term insomnia symptom rather than a major depressive episode. A brief course of a benzodiazepine such as lorazepam can relieve the sleep symptom, while supportive psychotherapy is the core intervention; antidepressants are not indicated unless criteria for depression are met.
Why each option
- A.
- Correct, a short course of a benzodiazepine targets the acute insomnia in a grief reaction.
- B.
- An SSRI is not indicated because she does not meet criteria for a depressive disorder.
- C.
- A tricyclic antidepressant is neither first-line nor indicated for this short-lived grief reaction.
- D.
- An antipsychotic is inappropriate as there are no psychotic symptoms.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed., 2015
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