For a patient diagnosed with major depressive disorder who does not want psychotherapy, what is an appropriate first-line medication?

Sertraline (Zoloft®) is considered an appropriate first-line medication for patients diagnosed with major depressive disorder who prefer not to engage in psychotherapy. This selective serotonin reuptake inhibitor (SSRI) is widely recognized for its efficacy, safety profile, and favorable tolerability, making it a common first choice in treatment guidelines for depression. SSRIs, including sertraline, work by increasing serotonin levels in the brain, which can help elevate mood and alleviate depressive symptoms.

The extensive research supporting the use of sertraline and other SSRIs highlights their effectiveness in reducing depressive symptoms, along with a comparatively lower risk of side effects than older classes of antidepressants. This makes sertraline not just suitable, but often the preferred option, especially in patients who may be hesitant about more intensive treatments like psychotherapy.

While other options like bupropion, amitriptyline, and trazodone may be utilized depending on individual patient circumstances and specific symptoms, they do not generally occupy the same first-line status in the treatment hierarchy for major depressive disorder as sertraline does. Bupropion might be considered, especially in cases of depression with fatigue or lack of motivation, but it is not as universally recommended as sertraline.