Compared with its use in major depressive disorder, pharmacological treatment of OCD with SSRIs characteristically requires:
- A Lower doses and a shorter trial duration
- B Higher doses and a longer trial duration before judging response ✓
- C Identical doses and duration
- D Higher doses but a shorter trial duration
Correct answer: B. Higher doses and a longer trial duration before judging response
Explanation
In OCD, SSRIs are titrated well above antidepressant doses, for example fluoxetine up to 60 to 80 mg and sertraline up to 200 mg, and an adequate trial lasts 8 to 12 weeks before response is judged, compared with 4 to 6 weeks in depression. This slower, delayed antiobsessional effect is a standard teaching point and explains why many apparent treatment failures are actually premature discontinuations. Option D reverses the duration requirement and is the most tempting error.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed.
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