How to make my Brother Normal hasn't been outside in years

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I think he would enjoy being invited to things even if he always says no, and plus it's a sign of respect. My guess is something like every couple of weeks is perfectly fine. And different kind of events including such things as going to the beach where you don't have to be dressed your best. Just don't overpush.

With the OP's brother, it sounds like OCD is a definite possibility.

And OCD can be helped with medication such as prozac, just that the first medication may not be the one which works. And when switching or discontinuing, sometimes important to phase down in steps even if it didn't seem to be working.

Plus, (nondogmatic!) forms of cognitive behavior therapy can be helpful.

Plus, some beginning research that of the subset of rapid-onset OCD, maybe approximately 50% of these cases caused by PANDAS. Some doctors remain skeptical, but the theory is that antibodies to strep attack the brain's basal ganglia, so a lot like rheumatic heart fever where it's the antibodies and not the strep itself. So far they're only looked at this in children (gee, sounds a lot like autism research) but it could well affect adults, too. A treatment is longterm antibiotics like a person might take for acne or an ear infection.
http://www.wrongplanet.net/postt232970.html

50% of rapid-onset cases, maybe, but most OCD isn't PANDAS... In any case, the treatment is similar whatever the origin. Thankfully OCD is treatable. That could mean a better prospect than if it were just autism, actually, since OCD as an anxiety disorder can be handled in various ways and go into complete remission. If an autistic person with OCD resolves the problems with OCD, he'll have much more brain left over to deal with the autism effectively.

maybe you can get a psychiatrist to come to your home and give advice on what to do. it seems to me like he needs professional help

The treatment can be different. If it's likely to be PANDAS, one treatment is prophylactic antibiotics.

Granted. Antibiotics are on the list of things to try, mostly because antibiotics are a relatively harmless thing to try. But AFAIK it is not known how helpful it is, because the damage has probably been done by the time the OCD symptoms show, and the strep is long gone by the time a doctor catches on that it's PANDAS and not regular OCD. I guess maybe if you saw unusually rapid onset in an unusually young child you'd just treated for strep, you might catch it in time for antibiotics to help wipe out whatever was left.... But CBT is the preferred treatment for either kind of OCD and even if they do antibiotics, if it's been there for any length of time there'll be a behavioral angle that has to be worked out through therapy.

Prophylactic antibiotics are not always harmless...google "fluoroquinolone toxicity syndrome," the FQ antibiotics have crippled a lot of people. And there's no predicting who will get the worst side effects. Really can't play around with Big Pharma these days, now that they pass executives back and forth between themselves and the FDA. My .02. Be very very careful whatever you take.

Has the OP given an update lately?

Someone I know with very similar description to the OP's brother got better after years of in home therapy - the therapist comes to the home. It's expensive though, unless you have a socialized medicine maybe.

His profile shows he was on the site yesterday but no additional posts have been made.
I have doubts as to the integrity of the OP personally.

Sometimes people expect to go on forums and talk about their autistic relatives and be told, "oh, you poor thing, you have to deal with such a horrible life, I feel for you having the tragedy of having an autistic relative"... Yeah, we don't do that 'round here. Most of us are autistic. For us, autism is normal. It's kind of hard to react with horrified sympathy when somebody's describing something that's totally everyday and unremarkable to you.

I've been to a few of those places. They're essentially bitchfests about how horrible it is to raise an autistic child or have an autistic spouse or whatever, and it just feeds on itself... Makes me feel like I'm a black person sitting around watching the KKK talk about how horrible it is that black people exist. I can never stay long.

Thankfully most places aren't near that bad, but they exist. Wish they didn't.

But yeah, I think maybe the OP is a bit surprised that most of us don't think it's feasible or a good idea for his brother to magically turn normal. It took me a while to get used to the idea that it was okay for me not to be normal, though, so I can't really get on his case about it.

Sure, I understand and appreciate what WP has to offer.
I'm just wondering if the situation being debated is actually real.
A number of members, Including myself, have offered advice and made queries that have received no response.

Meh. Worst that can happen is that somebody posts a fake question that's realistic enough for us to try to answer it, and then somebody in a similar situation comes along and sees it's relevant to them. Could still be useful to somebody, even if the OP is pure fabrication.

I like your optimism.

<--- Hates fake questions.

I think the goal of prophylactic antibiotics is to prevent repeated waves of damage to the basal ganglia.

The OP's brother reminds me of myself at age 17 and 18. At first I took hour long showers with ritualistic soaping and rinsing. Then, perhaps as the stress of doing it just right increased, I would put off taking showers. I would only take showers once every three or four days, sometimes longer, when it became too obvious my hair was greasy. Yes, it was embarrassing. And I could feel the social rejection.

Sometimes hygiene is a luxury.