Rosh Psychiatry Board Practice Exam

A 35-year-old woman has an increasing fear of flying. What is the most appropriate therapy for her?

1. Venlafaxine

2. Paroxetine

3. Sertraline

4. Lorazepam

The correct answer is: Lorazepam

For a patient with a specific phobia, such as an increasing fear of flying, the most appropriate therapy often involves a behavioral approach, particularly cognitive-behavioral therapy (CBT) or exposure therapy, rather than medication alone. However, in the context of short-term management of anxiety related to flying, benzodiazepines like Lorazepam can be beneficial for acute anxiety relief. Lorazepam is effective in reducing anxiety symptoms in the short term, particularly in situations where immediate relief is needed, such as before a flight. It acts quickly to alleviate the physiological symptoms associated with anxiety, making it suitable for a person who is anxious about flying in the near future. While the other options (such as Venlafaxine, Paroxetine, and Sertraline) are effective antidepressants and anxiolytics often used for generalized anxiety disorder or other anxiety disorders, they typically may not provide the rapid relief of acute anxiety symptoms related to a specific situation like flying. They also usually require some time to take effect and aren't usually the first choice for immediate anxiolytic effects required in specific phobias. In summary, for this patient, who is experiencing an acute increase in fear related to flying, the immediate use of Lorazepam