Shafi Lodhi, MD

Narrative of Services:

Bay Area Neuropsychiatry is a telemedicine practice offering psychiatric and neuropsychiatric care for OCD across the full spectrum: from new diagnoses to treatment-resistant presentations. Services include comprehensive diagnostic evaluation, evidence-based pharmacotherapy (SSRIs at OCD-range dosing, clomipramine, and augmentation strategies when warranted), management of co-occurring ADHD, mood, anxiety, and tic disorders, and coordinated care with ERP-trained therapists. The neuropsychiatric framing is particularly useful when OCD overlaps with tic disorders, executive dysfunction, or other neurobehavioral features. We see patients via telemedicine across multiple licensed states.

Treatment of Co-occurring Disorders:

My approach prioritizes diagnostic clarity before sequencing treatment. I stabilize the most functionally impairing condition first, while treating OCD with adequate-dose SSRI trials and clomipramine when indicated. With ADHD, I monitor stimulants for OCD symptom shifts. With mood disorders, I screen for bipolarity before antidepressant initiation. With anxiety, I leverage shared SSRI mechanisms but titrate to OCD-range doses. With tics, I consider alpha-2 agonists or agents addressing both phenotypes. I coordinate closely with ERP-trained therapists, pharmacotherapy alone rarely suffices. When response stalls, I revisit formulation rather than reflexively augment.

Training Description:

My training includes general adult psychiatry residency, followed by dual fellowships at Stanford in neuropsychiatry and forensic psychiatry. OCD was integrated throughout this training, particularly within the neuropsychiatric framework where OCD overlaps with tic disorders, basal ganglia circuitry, and treatment-resistant presentations. I subsequently held a faculty affiliation with Harvard Medical School / Massachusetts General Hospital. I have approximately 9 years of clinical experience treating OCD across outpatient, consultative, and telemedicine settings, with ongoing engagement in the literature on OCD pharmacotherapy, comorbidity management, and treatment-resistant approaches.

Diversity Statement:

My practice serves patients from diverse cultural and religious backgrounds, including substantial work with South Asian, Middle Eastern, and Muslim communities; populations underrepresented in much OCD research and treatment literature. I have particular familiarity with religious scrupulosity presentations and the clinical task of distinguishing authentic religious practice from OCD-driven compulsions or pathological reassurance-seeking, and I’m comfortable coordinating with religious authorities as adjunct support when patients wish. I attend carefully to family-system dynamics, intergenerational stigma around psychiatric care, and culturally specific shame that often shapes help-seeking and treatment adherence.

Formal cultural competency training is integrated into psychiatric residency and fellowship including the DSM-5 Cultural Formulation Interview, attention to language, religion, and immigration history in psychiatric presentation, and the culturally informed assessment that forensic psychiatry requires. My Stanford fellowship training emphasized this in evaluees from diverse cultural and linguistic backgrounds. Beyond formal training, my background as a physician of South Asian Muslim heritage informs my work with patients navigating cultural and religious frameworks around mental illness, and I read ongoing literature on cross-cultural and religiously informed psychiatric care.