Hi doctor, My brother, who is 32 years old, is undergoing treatment for OCD for the last 15 years without much improvement. In fact, his condition has only worsened since the start of the treatment. For the last several days, he has been complaining of erectile dysfunction, urinary hesitancy, drooping of the lip to one side during smiling, occasional numbness in extremities, etc. He has significant loss of memory (only short term) and behavioral problems. He asked me if he should be further investigated to rule out organic disease if any. So, I advised him am MRI (myself an MBBS doctor). MRI showed multiple hyperintense lesions in bilateral frontal lobes, parietal lobes and these changes were attributed to chronic ischemia by the radiologist. Now, I am concerned if his condition is merely a psychiatric disorder or a result of some organic disease. He was never investigated earlier, and all this time he was put on SSRIs and benzodiazepines for OCD. Kindly do help me regarding the same and guide me for the next step in his workup. His current medicines are tablet Fludac twice daily and tablet Clonafit 0.5 mg thrice daily.
Hi. First of all what you mentioned over in the MRI report could be coincidental finding, and there is less to do with these changes if OCD (obsessive-compulsive disorder) is considered provided there is no family history of OCD or related psychiatric disorder. Now regarding the changes before searching anything, there is a definite need to see the reason behind the chronic ischemic changes. Although the most common causes are diabetes and high blood pressure, consistent hypotension (low blood pressure) can be another reason for ischemic changes. For further information consult a psychiatrist online -->