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Mr Singh is a 50 year old chef who presents to the GP surgery with a 3 month history of low mood and poor sleep, in particular falling asleep. He lives alone and is finding himself increasingly less motivated to go out and take a walk or socialise with friends. He has a supportive daughter who visits regularly and has encouraged him to see the doctor to discuss his mental well-being. He denies any suicidal thoughts and there are no features of psychosis.

Past medical history includes severe knee Osteoarthritis and Migraine for which he takes Ibuprofen, Paracetamol and Sumatriptan. Mr Singh is a non-smoker with a BMI of 24 and drinks no alcohol. He is very reluctant to try counselling and hopes medication can help. You explain to him that he has features of Depression and agree to start a medication.

Which one of the following medications would be most appropriate?

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