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Problem: A 30-year-old man presents to his primary care physician for an annual check-up. When asked if he ever feels depressed, the patient initially says no, then admits that he was "previously having a really hard time in my marriage, but right now it is slightly better." These symptoms have been going on for 3 months now, most days. He is having trouble getting enough sleep at night and is frequently waking at 4:00am and is not able to get back to sleep. His appetite has declined, and he has lost 10lbs since his last check-up 6 weeks ago. The patient previously contemplated death, and currently admits occasional suicidal permeations, yet has not formed a plan of carrying it out. He is also having problems concentrating at work. He talks about his kids (he and his wife have 2) and his worries for them. He worries what their lives will be like if they "turn out like" their dad, a "meaningless, no-consequence kind of person." If this patient has a partial response to fluoxetine, which was initiated during his prior checkup, would augmentation be plausible?
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