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NBME2 block1#26, please help - doubleblessing
#1
26.) Five months after beginning fluoxetine to treat obsessive-compulsive disorder, a
19-year-old man states that he discontinued his medication 2 months ago because
he had begun to worry about taking his medication every day. His initial response
to the medication was good. His symptoms have now returned, and his morning
ritual of cleaning and grooming consumes so much time that his job is in jeopardy.
In addition to education about the nature of his disorder and its treatment, which
of the following is the most appropriate next step in management?


A) Tell the patient to schedule a return visit as needed

B) Offer to change the medication

C) Request that the patient's parents superviseadministration of medication

D) Monitor the patient's compliance by weekly blood tests

E) Begin a trial of cognitive-behavior therapy


is it E?
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#2
very deeply debated question in other threads i read. no consensus on an answer was found. (B vs E)
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#3
anyone has more opinion about this one? if change, what long term SSRI can be used for his compliance
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#4
Why not C,
since pt.discontinued his medication because
he had begun to worry about taking his medication every day
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#5
he is 19, maybe he is away from parents in college now. I would consider E or if change something which can give to him once twice a month, or atleast a week, but don't know any SSRI is in such form
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