Behavioral Science & Ethics USMLE Step 1 Practice Question

An 18-year-old woman presents to her primary care physician with a 3-week history of depressed mood, anhedonia, insomnia, and significant fatigue. She reports decreased appetite, psychomotor agitation, and difficulty concentrating on schoolwork. She recently withdrew from her college softball team, which she had previously enjoyed. She denies suicidal ideation but describes feeling worthless about her academic performance. Vital signs are normal; BMI is 18 kg/m². Physical examination, CBC, comprehensive metabolic panel, and thyroid function tests are all unremarkable. Which of the following is the most appropriate initial pharmacotherapy for this patient?