Rosh Psychiatry Board Practice Exam

In a case of a college student presenting with anxiety related to germs, which medication is most appropriate for treatment?

1. Bupropion

2. Clozapine

3. Fluoxetine

4. Lorazepam

The correct answer is: Fluoxetine

The most appropriate medication for treating anxiety related to germs, often associated with obsessive-compulsive disorder (OCD) or specific anxiety disorders, is fluoxetine. As a selective serotonin reuptake inhibitor (SSRI), fluoxetine has been shown to effectively reduce anxiety and obsessive thoughts by increasing serotonin levels in the brain. This mechanism makes it particularly suitable for anxiety disorders, including those characterized by compulsions and obsessions related to cleanliness or germs. Fluoxetine is not only commonly prescribed for general anxiety but is also one of the first-line treatments for OCD. The chronic nature of OCD and anxiety necessitates medications that can provide both immediate and long-term relief, which fluoxetine can offer. Other options, while potentially relevant in different contexts, do not address the specific needs of a student struggling with anxiety about germs as effectively. For instance, bupropion, primarily used for depression and smoking cessation, does not target anxiety symptoms specifically. Clozapine is an antipsychotic medication usually reserved for treatment-resistant schizophrenia and carries significant side effects that make it inappropriate for anxiety-related conditions. Lorazepam, although helpful for short-term anxiety relief, can lead to dependence if used long-term, and isn't the best choice for managing anxiety disorders effectively over