An 80-year-old woman is brought to the office for consultation about depressive symptoms that have waxed and waned over the past 8 weeks. History includes a diagnosis of probable Alzheimer disease. The patient has been taking sertraline for about 7 weeks, adjusted to a current dosage of 150 mg/d. Her depressive symptoms and signs have not improved, and the medication appears to be associated with nonspecific GI complaints, including nausea.

Which of the following is the most appropriate recommendation for this patient?

 (A) Continue the current dosage of sertraline for 3 more weeks.

 (B) Increase the dosage of sertraline.

 (C) Switch to an antidepressant with a different mechanism of action.

 (D) Augment the sertraline with aripiprazole.

 (E) Discontinue sertraline and observe for several weeks.