Cobalamin deficiency presenting as obsessive compulsive disorder: case report.

Cobalamin deficiency commonly presents with a wide range of neuropsychiatric manifestations ranging from myelopathy, neuropathy, optic neuritis and dementia to mood disorders, chronic fatigue and psychosis even without classical hematological abnormalities like anemia and macrocytosis. However, obsessive compulsive disorder (OCD) in relation to vitamin B12 deficiency has not been described so far. We report a case of middle-aged man presenting with OCD, low serum cobalamin and a positive family history of vitamin B12 deficiency who responded well to methylcobalamin replacement.

Treatment for late-onset obsessive-compulsive disorder with parkinsonism.

Dysfunction of the basal ganglia and frontal subcortical structures occurs in both obsessive-compulsive disorder and parkinsonism. Treatment of obsessive-compulsive disorder with parkinsonism is a therapeutic challenge, especially in old age as selective serotonin reuptake inhibitors may aggravate motor symptoms and worsen clinical conditions. The authors present a series of patients with late onset obsessive-compulsive disorder demonstrating improvement in obsessive-compulsive disorder as well as parkinsonian signs.