GABARITO: ALTERNATIVA B

Explanation:

SSRIs are first-line therapy for major depressive disorder (MDD). Their therapeutic effect is delayed because of gradual neuroadaptation (eg, downregulation of postsynaptic receptors, changes in second messenger signaling). While some patients notice early improvement in sleep and appetite, full antidepressant effects typically require 4–6 weeks of continuous therapy.

Therefore, at 3 weeks, it is expected that this patient has not yet experienced full benefit. The appropriate step is to continue therapy and reassess at 6–8 weeks. Switching or augmenting treatment is considered only after an adequate trial(≥6 weeks at a therapeutic dose).

Educational Objective:

SSRIs and other antidepressants require 4–6 weeks of continuous use before achieving full therapeutic benefit. Lack of improvement at 3 weeks reflects an insufficient treatment duration, not treatment failure.

Answer Choice Explanations