A 49-year-old woman is seen in the family medicine clinic for severe hot flashes and night sweats that wake her several times each night. She was diagnosed with estrogen receptor-positive breast cancer 8 months ago and has been taking tamoxifen since completing surgery. Three months ago, paroxetine was started for a major depressive episode, and her mood has partly improved. Her menses have become irregular, and she is fatigued from poor sleep. She has 10 hot flashes per day, no personal or family history of venous thromboembolism, and her examination is unremarkable.
| Heart rate | 76/min |
| Respiratory rate | 14/min |
| Temperature | 36.8 °C |
| O2 saturation | 98%, room air |
| Blood pressure | 124/76 mm Hg |
Question 1 of 28
Which one of the following is the most appropriate change to her medications at this visit?
Select 1. (0 / 1 selected)
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