Rosh Psychiatry Board Practice Exam

In the case of a woman who believes a weatherman is in love with her, what is the most appropriate therapy to consider?

1. Aripiprazole

2. Clozapine

3. Haloperidol

4. Sertraline

The correct answer is: Aripiprazole

In the context of a woman experiencing a delusion, such as believing that a weatherman is in love with her, the most appropriate therapy to consider would be aripiprazole. Aripiprazole is an atypical antipsychotic that is commonly used to treat conditions characterized by psychotic symptoms, including delusions. It works by modulating dopamine and serotonin receptors in the brain, which can help alleviate these symptoms effectively. Atypical antipsychotics like aripiprazole are generally favored in managing delusions because they provide a balance of efficacy with a favorable side effect profile compared to traditional antipsychotics. In this case, addressing the underlying psychotic symptom through the use of aripiprazole could help the patient gain insight into her beliefs and reduce her distress. Other medications listed, such as clozapine and haloperidol, are less optimal for first-line treatment in cases where the patient is experiencing delusions without other severe symptoms that might warrant their use. Clozapine, in particular, is reserved for treatment-resistant cases due to its side effect risks, while haloperidol, though effective, can carry a higher risk of extrapyramidal symptoms. Sertraline, an SS