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  • Psychotherapeutic intervention, esp. cognitive behaviour therapy for obsessions

  • Refer for group therapy

  • Any SSRI antidepressant (e.g. fluoxetine 20 mg (o)/d) is first-line pharmacological treatment—if required

  • Second line: clomipramine 50–75 mg (o) nocte, increasing every 2–3 d to 100–250 mg orally (o) nocte

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