Out of control 14 year old - OCD/Aspergers

Thought things were gettng better when he started on medication but its just as bad as before now.

!4 years old behaviour is just appaling. It affects everyone in the family. His 4 year old sister. His mum has fibromyalgia which is getting worse.

He uses every trick in the book to get what he wants now. He lies constantly, hes manipulative. Whatever you tell him he just does what he wants anyway. Hes also started using his illness OCD as an excuse not to do things. He also deveopled strange new things like spraying anti-bac spray onto his bits after using the toilet (which is not good).

Also, apparently its all our fault as parents because we made him like this by stressing him out all the time.

Constant letters from school now about homework etc.

Hes done none of the homework given to him by counsellor. Basically, makes zero effort to help himself. Seems happy to just go along as he is, shout at everyone and get his own way. Counsellor has pretty much said to us that she can do no more him until he decides to help himself.

We're been trying to treat him fairly but still sticking to basic house rules. Nothing too difficult. Just put things back, consideration for others (inc dont use all the hot water every day in the shower for an hour!), no shouting and screaming, homework gets done. Thats it. Nowhere near at the moment.

Are we taking the right approach? I guess we should still have rules in the house.