Obsessive-Compulsive Symptoms After Tirzepatide Treatment: A Case Report

Abstract

Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder characterized by obsessions and compulsions that are time-consuming, distressing, and cause significant impairment in functioning. Obsessions are recurrent, intrusive, and unwanted thoughts, urges, or images, while compulsions are repetitive behaviors or mental acts performed to reduce the distress associated with these obsessions or to prevent perceived harm. OCD affects approximately 1–3% of the population and typically begins in adolescence or early adulthood. If left untreated, it usually follows a chronic or progressive course. A 29-year-old male with a two-year history of obesity presented to our clinic for weight management. His body mass index (BMI) was calculated as 36.1 kg/m². The patient had previously been treated with metformin for insulin resistance; however, therapy was discontinued after three months because of gastrointestinal intolerance, and tirzepatide was then initiated. At the 11th dose of tirzepatide, the patient reported a three-week history of worsening intrusive thoughts and increased stress, for which he was referred to psychiatry. His family history revealed that his father had been diagnosed with OCD for 20 years. The patient was diagnosed with OCD by the psychiatry department and initiated on psychotherapy and a selective serotonin reuptake inhibitor (SSRI), with subsequent improvement of his obsessions and compulsions.