The answer is C. This man has recurrent, intrusive, unwanted thoughts that are distressing and anxiety provoking-- these thoughts are the Obsessions in Obsessive-Compulsive disorder (OCD). One does not need to have clear compulsions to make the diagnosis. Compulsions are behaviors or acts that are usually in response to an obsession, with the aim of reducing the anxiety or stress. Median onset of OCD is age 20, and it will often manifest in childhood. SSRI’s such as C) Sertraline are first line treatments. Clomipramine (most serotonin selective TCA) can also be used. Atypical antipsychotics (D) Quetiapine can be used to augment, but are not first line as monotherapy. SNRI’s (B) Venlafaxine have not been shown to be more effective than SSRIs in OCD. (A) Benzodiazepines may relieve short term anxiety but are not used as long term treatments of OCD. Cognitive Behavioral Therapy can be used in combination with pharmacotherapy, or less commonly as monotherapy.
Publication reference : Reference: Pittenger C, Bloch MH. Pharmacological treatment of obsessive-compulsive disorder. Psychiatr Clin North Am. 2014 Sep;37(3):375-91. Doi: 10.1016/j.psc.2014.05.006. Review. PubMed PMID: 25150568
Reference URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143776/
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