Q. A 38 year-old man is severe depressed and has been on and off throughout his life. He has tried numerous antidepressants but has pretty much given up on them. Although they are effective, they often have such terrible side effects, they don't make it "worth it" to continue on them. You run down the list of potential side effects he has struggled with. He rattles off many, including sleep issues, weight changes, severe constipation, dry mouth, and then, with hesitation, he reports that the worst was an inability to ejaculate (which was strange for him because typically he would be anxious about ejaculating "too soon"). He has no other major medical problems. He denies use of tobacco or illicit drugs, but admits to intermittent heavy alcohol use (binge drinking). His vital signs are normal and his exam is unremarkable. Which of the following is the appropriate next step?