Review Question - QID 214279

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Obsessive-Compulsive Disorder Treatment Medical QID: 214279 (M1.OMB.20.1)

QID 214279 (Type "214279" in App Search)

A 20-year-old man presents to the university mental health clinic with a 4-month history of increased worrying. He says that starting this semester, he began fearing that he was forgetting something whenever he left his dorm room. Over time, this fear has progressed to the point where he needs to check his backpack over 20 times before leaving for class. He does not want to have these thoughts but says that he cannot help himself. He finally came to be evaluated because these behaviors have started making him late for classes and tests. He has the same problem when he prepares for social encounters; however, he says that he enjoys being with friends when he finally arrives. Which of the following drugs is the most appropriate treatment for this patient?

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Fluoxetine

82%

66/80

Fluphenazine

1/80

Lithium

2/80

Methylphenidate

5/80

Selegiline

5/80

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This patient who presents with intrusive worrying thoughts of missing items that are relieved by checking most likely has obsessive-compulsive disorder, which can be treated with selective serotonin reuptake inhibitors such as fluoxetine.

Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by recurring intrusive thoughts that cause distress and repetitive actions that relieve distress. The thoughts in this disorder are ego-dystonic insofar as the individual experiencing them realizes that they are not reasonable or productive. Nonetheless, patients with OCD will not be able to control the thoughts that cause increasing distress over time. After the thoughts cause distress, patients with OCD will then perform repetitive actions that relieve the distress. These actions can be extremely prolonged or exaggerated to the degree where they result in considerable impairment in daily function. A combination of cognitive behavioral therapy and selective serotonin reuptake inhibitors can be used to treat OCD.

Incorrect Answers:
Answer 2: Fluphenazine is an antipsychotic medication that is used in the treatment of schizophrenia. Schizophrenia will present with positive symptoms such as delusions and hallucinations as well as negative symptoms such as social withdrawal and flat affect.

Answer 3: Lithium is a mood stabilizer that is used in the treatment of bipolar disorder. Bipolar will present as episodes of mania combined with extended episodes of depression.

Answer 4: Methylphenidate is a stimulant that is used in the treatment of attention deficit hyperactivity disorder. This disorder will present with an inability to concentrate and increased activity in more than one context.

Answer 5: Selegiline is a monoamine oxidase inhibitor that is specific for the B isoform of this protein. This drug is used in the treatment of Parkinson disease but would not be used in psychiatric disorders.

Bullet Summary:
Obsessive-compulsive disorder can be treated with a combination of cognitive-behavioral therapy and selective serotonin reuptake inhibitors.

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