Problem:
The patient is a 41-year-old female with a history of MDD. CC: "I need to get out of this dump." Endorsing: low motivation, loss of interest, and sleep disruptions. Past psychiatric medications: Mirtazapine 15 mg PO at bedtime caused weight gain and helped with sleep.
Gabapentin 300mg orally daily at bedtime for pain did not help.
The patient was on Sertraline for the past three years and Zolpidem 5mg orally daily for sleep, but it was not working. She is requesting an increase in Zolpidem. How will you manage this patient's medications?