Sunday, May 24, 2009

Brain Stimulation for Treatment Resistant OCD

Obsessive-Compulsive Disorder (OCD) is a chronic condition, affecting about 2.2 million Americans. People have intrusive, distressing thoughts that are relieved by engaging in compulsive behaviors. Most people receive at least some benefit with behavior therapy and/or medications. Some, however, are treatment resistant. The FDA recently approved Medtronic’s Reclaim Deep Brain Stimulator device for those who have failed to benefit from other treatments.

The Reclaim device is implanted under the skin of the chest and then connected to four electrodes in the brain. The electrodes deliver steady pulses of electricity to areas of the brain that control mood and anxiety. Similar devices have been used since the 1990’s to treat movement disorders like Parkinson’s disease and tremors.

Many don't realize the impact OCD can have on people's lives. Minimally, those with OCD are miserable from the worries and the compulsions. It affects some to the extent of losing or preventing relationships. Others may be unable to work. Some are even unable to leave their homes.

“Reclaim is not a cure,” Dr. Daniel Schultz said in a statement. “Individual results will vary and patients implanted with the device are likely to continue to have some mild to moderate impairment.”

Behavior therapy for OCD is generally necessary for optimal benefit. Yet, no one is spending millions of dollars to refine this treatment and/or to teach these techniques to more therapists. Medications and medical treatments such as this will cost much more than behavioral treatments. The difference is that Big Pharma has millions to market the medical treatments.

It will be interesting to see what, if anything, happens legislatively and otherwise with coming attempts at refining our medical and insurance systems. I'm afraid that it is unlikely that 40 years of research showing even one therapy session cuts down significantly on the number of medical visits and medical costs will push for this to happen. The safer bet is to stay where the money is, which suggests this won't change much, if at all.

For more information on OCD and treatments, go to http://ocfoundation.org and http:drmikemiller.com/ocd.html

Best wishes,
Mike

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