ABSTRACT
Background: Obsessive Compulsive Disorder (OCD) can present with unusual symptomatology. Aim(s): To discuss a case of OCD with an atypical manifestation in an adult male teacher who has an obsession and compulsion of prescribing medications to the villagers and its management. Case Summary: A 35 years old male teacher presented with complaint of recurrent obsessional thoughts about prescribing medications to patients and compulsion for the same. He started having these thoughts after conducting duty at a community health center as a COVID-19 booth controller. He perceived these thoughts as intrusive, irrational, absurd, anxiety provoking and distressing;would trying to resist them, but won't be able to do so. He used to sit beside hospitals, squares in villages, and medical shops to find patients and prescribe medications to them to relieve his anxiety. After prescribing medications although his anxiety symptoms would decrease, but he would feel guilty about prescribing medication as he knew that is not an expert. He also faced financial issues as he used to buy medications for villagers, so that they allow him to prescribe medications. He was diagnosed as a case of OCD with good insight and was started on Tab. Escitalopram which was gradually built up to 20 mg over the 3 months along with psychoeducation and supportive sessions. Currently he is in remission and maintaining well since last 2 months. Conclusion(s): This case report illustrates that clinician should remain vigilant about the unusual presentations of OCD to avoid the misdiagnosis and timely management.