A 22-year-old woman presents in clinic to follow up on a recent diagnosis of generalized anxiety disorder. She started taking sertraline 25 mg per day for a week and then titrated up to 50 mg per day for the next five weeks. She hasn’t noticed any symptom improvement. Which of the following is the best next step? Add adjunctive alprazolam 1 mg per day in divided doses Add adjunctive duloxetine 60 mg per day Discontinue sertraline and start fluoxetine 20 mg per day Increase sertraline to 100 mg per day