Safety and Effectiveness of Gamma Capsulotomy in Intractable OCD

Inclusion Criteria

• •1. OCD, diagnosed by Structured Clinical Interview for DSM-IV (SCID-IV), judged of disabling severity with a Yale-Brown Obsessive Compulsive Scale (YBOCS) score of at least 30 and a Social and Occupational Functioning Assessment Scale (SOFAS) score of 45 or less.
• •2. Persistence of severe symptoms and impairment for five or more years despite: 1. at least three adequate (≥3 months at the maximum tolerated dose) serotonin transporter inhibitor trials (fluoxetine, sertraline, fluvoxamine, paroxetine, citalopram, escitalopram, or clomipramine) alone or in combination with, 2. adequate behavior therapy (≥20 sessions of expert exposure and response prevention), and 3. augmentation of one of the selective SRIs with clomipramine, a neuroleptic, and clonazepam.
• •3. Age between 18 and 65 years.
• •4. Able to understand and comply with instructions.
• •5. Able to give fully informed, written consent in the judgment of the Consent Monitor.
• •6. Either drug free or on a stable drug regimen for at least 6 weeks.
• •7. Good general health.
• •8. A family member or significant other is available and willing to communicate with the research team if the patient's clinical status worsens.
• •9. The local referring psychiatrist is willing to provide ongoing care.