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A 27-year-old man with obsessive compulsive disorder has checking rituals that make him two hours late for work most days. He completed 16 sessions of cognitive behavioural therapy with exposure and response prevention six months ago, with partial benefit. He has taken sertraline 50 mg daily for the past 12 weeks and reports no further change. He has no adverse effects, no depression and no suicidal ideation, and takes no other medicines. Which one of the following is the most appropriate next step in his drug treatment?
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