Case Files from the Ward: Episode 1 – OCD Nightmare

Real case. Real mistake. Real lesson.
A patient with debilitating OCD was prescribed:

Low-dose paroxetine
Daily alprazolam
Olanzapine
Lamotrigine
None of these were appropriate first-line interventions. This wasn’t just poor prescribing — it was dangerous.
In OCD, max-dose SSRIs are essential before augmentation. And augmentation with olanzapine? Risky — it can actually worsen symptoms.

This case reminded me how often we forget the fundamentals.

👉 Psych providers: What’s your SSRI of choice for OCD?
👉 Patients: Have you ever been underdosed and misdiagnosed?

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Disclaimer: This is not medical advice, and the information is provided for educational purposes only. Please consult your doctor for any specific medical questions. All content is created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider. If you think you have a medical emergency, call your doctor, go to the emergency department, or call 911. We do not endorse any specific treatment, tests, or procedures. Reliance on this information is solely at your own risk.

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