Presents a case report of a Kuwaiti male adolescent was referred the outpatient clinic of the Child and Adolescent Psychiatric Department of the hospital. Medical history and physical examination were unremarkable, with no tics or illicit drug use, and his electroencephalogram (EEG) and MRI had no pathological findings. His symptoms had started 1 year earlier, when he started to have ideas about cleanliness, compelling him to spend hours washing repeatedly. A few months after symptom onset, his parents sought psychiatric advice at an independent provider in the community. Baseline laboratory investigations including thyroid function tests were within the normal range. A diagnosis of obsessive-compulsive disorder (OCD) with secondary depression was set. Fluoxetine 20 mg/day and clonazepam 1 mg/ day were prescribed. Over 1 month, fluoxetine was escalated to 40 mg/day, with almost no response, as self-reported by the patient. This case is the first reporting successful lamotrigine augmentation in refractory juvenile OCD.