Deep Brain Stimulation Approved for OCD. Depression Next?
Yesterday, the FDA approved the Medtronic Reclaim Deep Brain Stimulator device for the treatment of obsessive-compulsive disorder (OCD). The Reclaim is the first deep brain stimulator (DBS) implant to be approved for OCD.
OCD is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as handwashing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety.
The Reclaim device is shaped like a pacemaker. It's implanted under the skin of the chest and connected to four electrodes in the brain that deliever pulses of electricity to block abnormal brain signals.
Dr. Paul Stypulkowski, Medtronic's senior director of recearch explained, "What deep brain stimulation does is modulate those circuits that we believe are hyperactive in patients with obsessive-compulsive disorder."
Although approxomately 2.2 million Americans have OCD, the Reclaim DBS device will be available only to a small group of patients who don't respond to other treatments.
In a statement, Dr. Daniel Schultz said, "Reclaim is not a cure... Individual results will vary and patients implanted with the device are likely to continue to have some mild to moderate impairment."
Medtronic also announced yesterday that they are starting a large DBS clinical trial of patients with depression. The study will start with 30 participants at five sites, and Medtroni plans for it to grow to up to 200 patients at 20 sites. This is good news for those with depression who don't respond to medications, but it will take several years for the trials to be conducted and the DBS device to be submitted for final FDA approval.
Perrone, Matthew. "FDA approves brain-zapping device to relieve OCD." Associated Press. Washington. February 19, 2009.
Kamp, Jon. "After Lont Wait, Medtronic Starts Big Depression Study." Dow Jones News Wires. CNNMoney.com. February 19, 2009.