Dear RJ45, I've been in the same boat as you for a long time and tried many things. My brother has been suffering with OCD (per docs earlier) with 6+ years, but is very intelligent and smart.  Not all of the years were bad. He has had good times where he got top notch jobs (but never could stick on), was enthusiastic, but never was fulfilled with anything. He is now 31 years old.  Has been seeing a psychiatrist, but did not take medicines regularly.  As a result, our family has been sorrowful all the time due to him.    My parents changed doc 3 months ago. This week, the doc told me he has schizo.  He has been seeing this new psychiatrist, but not often enough as required by the doc. He does not admit that he needs care. He knows he has a mental issue, but will not accept the fact. Does not want my parents or I or any friend to advise him of the importance of taking medicines.  Now, his BP shot up very high with brain working continuously perhaps.  Doc wants to get him admitted so we can treat the condition, but again he does not want to.  So, we are now trying to approach him from a physical condition standpoint.  So, I agree with Vicki M and Chistina that your best bet is to approach from his physical check-up standpoint.  Do not give any indication to him that he needs mental treatment. Good luck. Taking Svrta and Clonach medicines now with very high dose.  If you can help me find more info about these medicines, I'd appreciate.  Thanks