Which of the following is considered the first-line treatment for OCD (Obsessive-Compulsive Disorder)?

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AIIMS NORCET 8 Prelims Memory Based Paper 2025

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Answer 1

Correct Answer: Fluoxetine

Rationale:

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) and is considered a first-line treatment for Obsessive-Compulsive Disorder (OCD). OCD is a mental health condition characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed to reduce anxiety caused by these thoughts.
SSRIs, such as fluoxetine, work by increasing the levels of serotonin in the brain. Serotonin is a neurotransmitter that plays a key role in regulating mood, anxiety, and behavior. By improving serotonin levels, fluoxetine helps reduce the symptoms of OCD.
Fluoxetine and other SSRIs are preferred for OCD because they are effective in reducing both obsessions and compulsions, have a favorable side effect profile compared to other medications, and are generally well-tolerated by patients.

Explanation of Other Options:

Benzodiazepines

Rationale: Benzodiazepines are primarily used for short-term management of acute anxiety or insomnia. While they may provide temporary relief from anxiety symptoms, they are not effective for treating OCD. Additionally, they carry a risk of dependence and withdrawal symptoms, making them unsuitable for long-term treatment.

Antipsychotics

Rationale: Antipsychotics are sometimes used as an adjunct (add-on) treatment for OCD, particularly when symptoms are severe or when SSRIs alone are not effective. However, they are not considered first-line treatments due to their limited efficacy for OCD and their potential side effects, such as weight gain, sedation, and extrapyramidal symptoms.

Antidepressants (TCAs)

Rationale: Tricyclic antidepressants (TCAs) such as clomipramine have been used to treat OCD. While clomipramine is effective, it is generally not considered a first-line treatment because of its higher risk of side effects compared to SSRIs. These side effects may include dry mouth, constipation, dizziness, and potential cardiotoxicity in overdose.

(No Option 5 Provided)

Rationale: There is no fifth option provided in the question, so no explanation is necessary for this.

Conclusion:

Fluoxetine, an SSRI, is the first-line treatment for OCD due to its efficacy, safety, and tolerability. It is important to note that treatment for OCD often involves a combination of medication and cognitive-behavioral therapy (CBT), specifically exposure and response prevention (ERP), which has been shown to be highly effective in managing OCD symptoms.