Obsessive-Compulsive Disorder is a challenging chronic condition, often unresponsive to medicines and even psychotherapy. In such patients, Deep Brain Stimulation holds promise as an advanced surgical treatment for OCD patients. By means of the medical tourism facilitator, CureSureMedico, we connect patients to world-class treatment facilities that have patient-centered DBS treatment plans, maximizing benefits and minimizing side effects. Our partners are leading surgeons and specialists who have the best standards of patient safety and caring with compassion at the core.
How We Do It?
The process of DBS involves brain scans to determine the exact points in the brain where symptoms related to OCD originate. Two electrodes are implanted in such regions, and a neurostimulator—a small device, about the size of a pacemaker—is placed near the collarbone. It functions by sending mild electric pulses through the electrodes to modulate brain activity; hence, great suppression of OCD symptoms.
DBS is usually used in patients with very severe OCD which is not responsive to other therapies. Of these patients, 60 percent achieved significant alleviation of the symptoms. The effects are also long-term, with most patients been able to decrease their medication intake and consequently reduce side effects .
Safety
DBS is a safe and effective method of treatment. It has been passed by the U.S. The Food and Drug Administration has approved it for treatment-resistant OCD under a Humanitarian Device Exemption. The medical facilities we partner with have enormous experience performing this procedure. The level of risk of side effects occurring from the implantation is rather low: less than a 1 percent risk of bleeding and only a 3 percent risk of infection. These complications are rare and usually do not cause permanent damage. Side effects due to the electrical current themselves are minimal, so DBS is generally less onerous for most patients than medication.
Inclusion Criteria
In order to qualify for DBS, a patient will be thoroughly evaluated by physicians within one of our partner institutions. The ideal candidates for DBS have had debilitating OCD for a minimum of five years and have failed to respond to the following treatments:
At Least 25 Sessions: From a specialist; otherwise, at least eight with a generalist.
Medication Regimens:
Two trials of maximum dose of SSRI for 18 weeks the same is the case with the maximum dose SSRI with an antipsychotic
Doses of clomipramine are increased to maximum dose for at least 12 weeks
What OCD feels like for a sufferer?
In a Sufferer the problem of OCD penetrates in nearly life with the serving of dread, guilt, shame, fear, and doubt. These feelings propel them into compulsive and repetitive actions to try and ward off disaster, and to alleviate their distressing emotions. OCD fears focus on things that are most important to the sufferer, usually in terms of values, loved ones, or life purpose. For example, someone who has high regard for being kind would be afraid of unintentionally harming other people.
It provides no consolation to realize these fears are baseless ones, and the stigma of mental illness often delays diagnosis and treatment so that about 1%-2% of the global population suffer with OCD mostly in silence and pain.
Current Options to treat OCD
Treatment for OCD typically begins with exposure therapy. Exposure therapy is one way through which patients get challenged at experiencing the things they actually fear with diminishing levels of safety behaviors. For instance, a person fearing to harm others may start by sitting closer to a butter knife and go all the way to actually holding a sharper knife closer to their therapist at the far end, so as to learn how to withstand their anxiety and the uncertainty.
The first-line medications for OCD are serotonin reuptake inhibitors (SRIs/SSRIs), usually at higher doses than in depression or anxiety. Even with these modalities, treatment offers little hope of a cure. In one study, only 65 percent of patients after treatment with the usual tools of standard treatment (therapy and medication), and only 35 percent had full remission. Ten percent of OCD individuals do not improve with even massively intensified treatment.
The Promise of Deep Brain Stimulation
For the small group of people with very severe, resistant OCD, DBS offers new hope. Fewer than 400 people in the world have undergone this procedure. People like Avinash, who came to our agency seeking DBS, show that it is possible. Avinash developed very severe OCD early on: obsessions about germs and contamination led to debilitating rituals.
Before DBS, Avinash had been through many therapies and countless medications. He even attempted suicide a couple of times, regrettably. When he came to know about DBS, we made it possible for him to have it done at a hospital with which we were collaborating.
Mechanism of Deep Brain Stimulation
DBS is a neurosurgical process by which thin electrodes are implanted in deep brain structures, specifically within the ventral capsule/ventral striatum. The electrodes transmit electrical currents from pulse generators implanted in the chest. The exact mechanism is not very clear, however. DBS is thought to modulate—normalize—the firing between areas of the brain involved in information processing and decision-making. This, in turn, reduces hyperconnectivity in OCD, which plays into compulsive behaviors.
DBS is most commonly used in the management of Parkinson's Disease symptoms. In fact, it is the only treatment for psychiatric disorders that has been approved by the US Food and Drug Administration; however, it has also been used in other disorders like major depression, Tourette syndrome, schizophrenia, substance use disorders, PTSD, and eating disorders.
Because brain surgery is so invasive and carries with it a risk of infection or hemorrhage, the DBS is a treatment of last resort. In order to receive it, the patient must have extremely severe OCD in whom all other lines of treatment have been tried.
Barriers and Stigma
Despite the promising potential of DBS, it is not widely available and is often difficult to get insurance coverage for. Another barrier to receiving this cutting-edge treatment is stigma against psychiatric surgery on the brain.
A Way Forward
Even after the course with Dr Avinash was completed after one year, he was on trials of other medications, and the therapy was continuous. Advised to undergo surgery for DBS, the patient was programmed three weeks after the surgery. It means that the adjustment of settings goes for several weeks, and through a period of 6 to 12 months, most patients feel gradual improvement and anxiety start to decrease, along with the symptoms of OCD.
Continuous stimulation is usually given, although patients can be allowed to switch it off at night if it is disturbing. DBS works best when the treatment is continued with therapy and drugs. In Avinash's, the mode of treatment using DBS was found to reduce the OC symptoms by approximately 54%, and Avinash was found to do everyday activities that before he could not do.
Conclusion
Deep brain stimulation is a real breakthrough for patients with severe, treatment-resistant OCD. Though this is no cure, for many, it can significantly enhance their quality of life. Patients such as Dr. Avinash show that sometimes DBS can transform lives, finally giving hope and a chance to live a life of purpose—not out of fear. End ‣ CureSureMedico Built on a commitment to connect patients with world-class medical services, we make sure that the best possible treatment is meted out to the patient, suiting his needs.
Notes :
Repetitive: For patients with OCD, the life experience becomes marked by a foreboding sense of blanket guilt, shame, fear, and doubt, prompting the individual to repeat behavior compulsively.
Cognitive-behavior: There is no comfort in the fact that the phobia is, in and of itself, irrational, in addition with the stigma surrounding mental illness, which delays seeking diagnosis and treatment, respectively, the symptom requires a cognitive-behavior approach.
Avoiding: The OCD fears often relate to things that are most important to the patient and therefore lead to avoidance.
Cognitive behavior therapy: The first-line therapy for the management of OCD is cognitive behavior therapy, and the type that is primarily effective is exposure and response prevention.
Body dysmorphic disorder: OCD also frequently co-occurs with disorders such as body dysmorphic disorder, which also includes obsessions and compulsions.
Onset: The symptoms can start in childhood and continue into the adult age group.
Ordering: The patient may take much of the time in ordering things in a certain manner to assist them in keeping anxiety under control.
Panic: Obsessions are able to make an individual panic and get very uncomfortable.
Antidepressants: Antidepressant drug the only drug regimen that this particular patient is exposed to
Health professional: There is a need for health professionals' diagnosis for treatment to be effective.
Feared: Obsessions are usually to do with whatever is most important to the individual and feared outcomes to result in the compulsive behaviors.
Brain regions: DBS targets the brain regions where activity is attributed to symptoms of OCD.
Chronic and severe: Repetitive behaviors and rituals represent a group of children who may be chronic and severe in their presentations.
Obsessions: The compulsive behaviors present in OCD are driven by the intrusive thoughts and impulses.
Trichotillomania: In other than other conditions, trichotillomania can be contemplated for DBS when this type of obsession compulsive behaviour reaches a severe level.
Mental health professional: One should do all these issues with the advice or in the setup of a mental health professional to manage the problem of OCD.
Cortex: DBS can be targeted towards the cortex for reduction of OCD symptoms.
Personality disorder: OCD can coexist with other disordered conditions like personality disorder
Brain areas: The areas of the brain that are responsible for functioning could be the target in case of OCD in DBS
Symmetry: The OCD patients have the obsession with symmetry.
Institute of mental health: The researches on the Institute of Mental Health has proved the efficiency of DBS.
Etiology: Understanding what causes OCD is essential to design the correct treatments
Obsessions and Compulsions: Lingering obsessions and Compulsions are the hallmark of OCD
Streptococcal: most people believe that a streptococcal infection might be responsible partially for the onset disorders
Outpatient: DBS is carried out mainly as an outpatient procedure
Contaminated: Patients may have the fear of contamination or contamination other people and can spend hours on cleaning
Therapists: Treatments will never have a chance to work if therapists are not skilled experienced.
Obsessional: The characteristic feature of OCD is obsessional thinking.
National institute of mental health: The National Institute of Mental Health imparts the guideline for controlling OCD.
Brain area: DBS cures one affected part of the brain in OCD.
Cope: To cope with OCD, it is necessary to control anxiety and to curb compulsions.
Obsessional Obviously, intrusion obsession is a striking feature of OCD.
Mental Illness: OCD is only one of the different mental illnesses that may cause a person to experience devastating disablement.
Disablement: Severe OCD may, in fact, bring about significant disablement.
Impulse: The DBS device uses electrical impulses to block the brain circuits that cause symptoms.
