rTMS in Treatment of Obsessive Compulsive Disorder (OCD)

A Multicentre, Double-blind, Randomized, Placebo-controlled Study Evaluating the Efficacy, Safety, and Clinical Outcomes of Low Frequency, Repetitive Transcranial Magnetic Stimulation (Over Supplementary Motor Area (SMA) Applied Bilaterally and Simultaneously) Versus Sham (Placebo rTMS) Treatment for 6 Weeks, When Added to a Stable Pharmacotherapy in Subjects With Obsessive Compulsive Disorder (OCD).

Low frequency (1Hz) rTMS applied bilaterally and simultaneously over SMA for 6 weeks in addition to the standard treatment regimen for OCD, will lead to significant improvement in patients' symptoms. The clinical improvement detected by YBOCS, CGI and SF-36 QOLS scores will be statistically significant in active treatment group compared to sham (placebo) treatment group.

Inclusion Criteria:

• signed patient informed consent;
• primary obsessive compulsive disorder;
• YBOCS score at least 20;
• males/females 18-65yrs;
• treated with adequate dose of SSRI at least 8 weeks at some stage of illness;
• currently using adequate, stable dose of SSRI at least 4 weeks but not responding.

Exclusion Criteria:

• schizophrenia, other psychotic disorders, bipolar I, current major depressive disorder (HDRS(17)>18, substance/alcohol dependence within last 6 months;
• severe axis II;
• suicidal score>=6 on MINI;
• metallic implant in cranium;
• severe/unstable medical conditions;
• not responding to ECT or had TMS in last 6 months;
• history epilepsy;
• neurological disorder leading to increased intracranial pressure;
• severe cardiac disorder/intracardiac lines, pacemakers;