Medications have side effects (especially the ones used to anxiety/etc) and therapy has limited success with very smart people. It takes just one bad therapist for him not to trust the process.

..and he could just consider ocd his cross to bear. That thing he just has to learn to cope with. Medicating might seem like giving up.

Yeah but I want the show to say it. I mean, I know America loves its pills, but no one has even suggested to him or talked about it behind his back. Weird.