A 42 year old, unmarried, male musician, with no other systemic illness, was referred to us with the complaint of the regular and frequent use of metronidazole, ornidazole, mebendazole and albendazole on a daily basis, for more than last 12 years. Initially, he frequently consulted his general physician for recurrent, minor, abdominal discomfort, but he later continued to take the prescribed medicines intermittently, without any further consultation. Gradually, he felt that taking those medicines would make him less tense and apprehensive about his physical problems. He also found it easier to interact socially and to perform on stage.
Over the past 3-5 years, he went on increasing the number of pills to more 20 tablets per day. He denied any problem of mood, sleep or energy or any other unusual experience. He had no fixed idea about any specific disease, nor did he have any distressingly repetitive thought or action. No history of psychosis or any other substance abuse was reported. On the examination of his mental status, he was found to be anxious and he expressed concern over having to take the above mentioned medicines to be able to continue his activities. On the investigation of his physical condition, all his blood tests, electrocardiograms and the ultrasound of the abdomen were found to be normal. Psychometry revealed high neuroticism on the EPQ (the Eysenck Personality Questionnaire).
Our provisional clinical diagnosis according to the International Classification of Diseases (ICD-10) was the abuse of nondependence producing substances and the generalized anxiety disorder with the anankastic personality disorder. He responded very well with Paroxetine (25 mg daily) and a short course of benzodiazepine. He is presently enrolled under a psychotherapeutic management protocol.