Rosh Psychiatry Board Practice Exam

Which class of medication is most effective for managing a patient with persistent anxiety despite previous therapy?

1. Antibiotic

2. Antidepressant

3. Antipsychotic

4. Antitussive

The correct answer is: Antidepressant

The most effective class of medication for managing persistent anxiety in a patient who has not responded adequately to previous therapy is antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). These medications are commonly used as the first line of treatment for various anxiety disorders due to their favorable side effect profile and efficacy in reducing anxiety symptoms. Antidepressants work by increasing the levels of serotonin and norepinephrine in the brain, neurotransmitters that are often dysfunctional in patients experiencing anxiety. This enhancement of neurotransmitter activity helps alleviate anxiety symptoms and improves overall mood, making them particularly beneficial for patients who have not had sufficient response from other therapeutic interventions such as psychotherapy or lifestyle changes. In contrast, other medication classes listed like antibiotics do not have any role in the treatment of anxiety disorders, as they target bacterial infections rather than mental health conditions. Antipsychotics may be used as adjunctive treatment in specific cases, but they are not the primary first-line treatment for anxiety and can come with more significant side effects. Antitussives are designed to relieve coughing and bear no relationship to anxiety treatment. Thus, the demonstrated efficacy of antidepressants in effectively managing persistent anxiety is well-supported in clinical