surgical approaches in refractory obsessive compulsive disorder: from leukotomy to gamma knife surgery

Obsessive Compulsive Disorder (OCD) is a chronic and debilitating disorder that can cause significant distress and interference with daily functioning and impairment in quality of life, social and familial relationship. Selective serotonin reuptake inhibitors and cognitive-behavioral therapy are currently viewed as the first line treatments of choice for OCD. Approximately 30-40% OCD patients fail to respond to these treatments. Anterior capsulotomy, cingulotomy, limbic leucotomy, subcaudate tractotomy are used for the treatment of refractory OCD. The studies suggested that gamma knife capsulotomy caused improvements in 55-70% refractory OCD patients. Many studies suggest that psychosurgery is a beneficial, well tolerated and safe method. This study aimed to report efficacy, adverse effects and long term effects of surgery techniques especially gamma knife and deep brain stimulation in refractory OCD patients . [Archives Medical Review Journal 2015; 24(2.000): 239-250]