Efficacy of repetitive transcranial magnetic stimulation as an adjunctive treatment in resistant obsessive-compulsive disorder: A randomized controlled trial.

BACKGROUND

Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition, often resistant to pharmacotherapy. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential neuromodulatory treatment for resistant OCD. However, evidence regarding its efficacy in an Indian clinical setting remains limited.

AIM: To evaluate the efficacy of adjunctive low-frequency rTMS applied over the right supplementary motor area (SMA) in patients with treatment-resistant OCD.

MATERIALS AND

METHODS

A prospective, randomized, double-blind, sham-controlled study was conducted at a tertiary care center. Thirty treatment-resistant OCD patients were recruited and randomized into active rTMS (n = 15) and sham rTMS (n = 15) groups. rTMS was administered at 1 Hz frequency, at 100% motor threshold, for two weeks, followed by a four-week gap, and another two-week session. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores were assessed at baseline, posttreatment (two weeks), and follow-ups at six and eight weeks. A reduction of ≥25% in Y-BOCS score was considered a positive response.

RESULTS

A total of 28 patients completed the study (active n = 13, sham n = 15). Baseline demographic and clinical variables were comparable. Mean Y-BOCS reduction at eight weeks was significantly higher in the active rTMS group compared to sham (P < 0.05). Active rTMS was well tolerated, with headache being the most common adverse effect.

CONCLUSION

Low-frequency rTMS over the SMA shows promise as an adjunctive treatment for resistant OCD. Further studies with larger samples and extended follow-up periods are warranted.