A middle aged man presented with pain in back, lack of interest in recreational activities, low mood, lethargy, decreased sleep and appetite for two months. There was no history suggestive of delusions or hallucinations. He did not suffer from any chronic medical illness. There was no family history of psychiatric illness. Routine investigations including haemogram, renal function tests, liver function tests electrocadiogram did not reveal any abnormality. This patient should be treated with –

**Core Concept**
The patient's presentation suggests a diagnosis of **Major Depressive Disorder (MDD)**, characterized by persistent feelings of sadness, loss of interest in activities, and changes in sleep and appetite. The underlying principle being tested is the recognition of MDD and its treatment.

**Why the Correct Answer is Right**
The correct treatment for MDD typically involves the use of **antidepressant medications**, such as selective serotonin reuptake inhibitors (SSRIs), which are considered first-line treatment due to their efficacy and relatively favorable side effect profile.

**Why Each Wrong Option is Incorrect**
**Option A:** Incorrect because it is not specified, but typically, treatments other than antidepressants might not be the first line.
**Option B:** Incorrect for the same reason as Option A.
**Option C:** Incorrect as it is not the correct choice, but without the text, the exact reason is unclear.
**Option D:** Incorrect as it is not the correct choice.

**Clinical Pearl / High-Yield Fact**
A key point to remember is that **SSRIs** are often the initial pharmacological treatment for MDD due to their balance of efficacy and safety.

**Correct Answer:** D. Antidepressants.

✓ Correct Answer: B. Sertraline