Off the Deep End

In patients with severe, treatment-resistant obsessive-compulsive disorder (OCD), deep brain stimulation (DBS) may work, according to new research from Brown University.

Deep brain stimulation  treatment for OCD, according to the research, should be reserved for a small portion of patients who are severely disabled and have not demonstrated adequate recovery from "very aggressive use of conventional treatments."

DBS involved surgically placing electrodes in the brain's ventral capsule and nearby ventral striatum, both of which contain nodes in a network thought to be vital in OCD.

A previous study found 73 percent of 26 severe OCD patients who had received DBS showed at least a 25-percent reduction in their test score according to the Yale-Brown Obsessive Compulsive Scale. The new results indicate that patients who initially improve and continue to receive stimulation generally remain improved for eight or more years.

The study authors said DBS really just makes severely affected OCD patients into average OCD patients.

About one percent of the US population is diagnosed with OCD in a given year, and only a small subset of these patients would be considered candidates of DBS treatment. Antidepressant medications, such as Prozac® and Zoloft®, are most often prescribed for OCD along with psychotherapy.

The U.S. Food and Drug Administration (FDA) approved DBS for the treatment of extreme cases of OCD in 2009 under its humanitarian device exemption. The study was funded by the National Institutes of Health.