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Your next patient is 44 year old Jonathan who is known to have Obsessive Compulsive Disorder (OCD). He has seen several of your GP colleagues over the last 6 months and has had a poor response to CBT. He presents today frustrated and upset about his ongoing preoccupation with cleanliness. He has had to resign from his job in the retail sector and is feeling very low. He denies any thoughts of suicide or self harm but is desperate to improve his mental health.

He agrees to be referred to the secondary care team but wants to start medication in the interim. Past medical history includes Depression and he has previously had bad side effects with Fluoxetine and Citalopram.

What would be the next most appropriate management option?

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