rTMS in Treatment Refractory Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder
About this trial
This is an interventional treatment trial for Obsessive-Compulsive Disorder focused on measuring rTMS, treatment refractory, treatment resistant, SSRI, clomipramine
Eligibility Criteria
Inclusion Criteria:
- Patients with a primary diagnosis of OCD (DSM 5) according to the MINI
- Y-BOCS score of ≥20
- History of treatment-resistant OCD, established by a trained psychiatrist with extensive expertise in the OCD field. Treatment-resistance will be defined as non-response to at least two SRIs trials (clomipramine, fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, escitalopram).
Exclusion Criteria:
- Any additional current psychiatric comorbidity, except for mild depressive and anxious symptoms
- A lifetime DSM-5 diagnosis of schizophrenia or other psychotic syndromes, substance dependence or substance abuse, including alcohol, bipolar I or II disorder, mental disorder due to a general medical condition
- Serious suicide risk
- Episodic OCD
- Illness duration less than two years
- Hospitalization in the last 6 months
- Pharmacological treatment changes in the last 3 months
- The inability to receive rTMS because of metallic implants, or history of seizures (personal or family history of seizure in first degree relatives)
- Any major medical disease
- Pregnancy or nursing of an infant
- The inability or refusal to provide informed consent
- Prior TMS exposure (in order to reduce the risk of unblinding).
No psychotherapy and/or pharmacological treatment changes will be allowed during the study period. Pharmacologically treated patients should be on constant medications for at least 2 weeks before entering the study.
Sites / Locations
- MacAnxiety Research Center
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
Active rTMS
Sham rTMS
In rTMS, a device called a "stimulator" provides energy to a "magnetic coil". The coil is a handheld unit that delivers magnetic pulses. The coil is placed against the scalp on the top of your head. Sessions will occur once a day, 5 days/week, for 3 weeks.
The coil in the sham rTMS phase will be positioned 90 degrees off the scalp, with one wind of the coil touching the scalp. This will ensure that the participant will not be affected by the machine during this time. All other factors will be similar to the active rTMS phase.