On Demand OCD & Anxiety Lecture Series: Neurosurgery and Other Novel Interventions for Refractory OCD
This presentation was originally reviewed on April 10, 2023, and broadcast live online on April 7, 2023, from 2:30 PM – 4:15 PM ET.
The views and opinions expressed by this presenter in this lecture are their own, and do not represent the views of Sheppard Pratt.
Most individuals with OCD respond to standard treatment, including exposure and response prevention therapy and medications that act on serotonin. However, only a little more than one-third of suffers obtain complete remission, and approximately 10% of OCD sufferers continue to experience severe and disabling symptoms, despite receiving maximal conventional treatment. This presentation will cover treatment options that clinicians can consider to target residual symptoms in those who have responded partially, including medication strategies and non-invasive neuromodulation, including ketamine and transcranial magnetic stimulation (TMS). For the 10% who remain severely affected, we will discuss neurosurgical interventions, including deep brain stimulation (DBS) and lesioning procedures.
This activity is intended for physicians, nurses, psychologists, social workers, counselors, and other mental health professionals.
After this lecture, registrants will be able to:
- Formulate a treatment plan for OCD sufferers who continue to experience symptoms despite receiving maximal, standard treatments.
- Name three barriers to access to neurosurgical interventions for OCD and develop strategies to mitigate these barriers.
- List the inclusion and exclusion criteria for deep brain stimulation for severe and disabling, refractory OCD.
There is no commercial support for this activity.
About these speakers
Rachel A. Davis, MD is associate professor of psychiatry with a secondary appointment in neurosurgery at the University of Colorado Anschutz School of Medicine, where she serves as Vice Chair for Clinical Affairs in the Department of Psychiatry. Dr. Davis is Medical Director of the OCD Program, Co-Director of the OCD Surgical Program, and Director of the Psychiatric Neuromodulation and Advanced Therapeutics Service. She specializes in treating individuals with severe and refractory OCD, and CU Anschutz/UCHealth is one of just a few academic centers in the world providing deep brain stimulation (DBS) for OCD. Dr. Davis is interested in the use of DBS for other severe and refractory psychiatric illnesses and is a Principal Investigator on a National Institutes of Health BRAIN initiative, studying the ethics of DBS in schizophrenia.
Elizabeth Fenstermacher, MD is an assistant professor of psychiatry at the University of Colorado Anschutz School of Medicine, where she serves as the Medical Director of the Transcranial Magnetic Stimulation Service in the Department of Psychiatry. She also has an appointment through Children’s Hospital Colorado where she is integrated into the neurology department including multidisciplinary clinics treating patients with non-epileptic seizures, functional neurological disorders, and tics and tourette’s disorder. She specializes in treating children and adolescents with complex psychiatric and neurologic comorbidities, as well as treating adults with treatment refractory depression and obsessive compulsive disorder with TMS. She is also involved in several neuromodulation initiatives through the University of Colorado in particular several ongoing studies focused on the use of Deep Brain Stimulation for the treatment of severe psychiatric illness (OCD, Depression, Schizophrenia). Dr. Fenstermacher is interested in translating advances in our understanding of the neurobiology of psychiatric disorders to clinical practice and has developed and taught several neuroscience and genetics courses at different institutions including Brigham and Women’s Hospital, Cambridge Health Alliance, and Children’s Hospital Colorado as well as taught nationally and continues to contribute actively to the curricula of the National Neuroscience Curriculum Initiative where she is a Brain Trust Fellow.
Sheppard Pratt holds the standard that its continuing medical education programs should be free of commercial bias and conflict of interest. In accord with Sheppard Pratt's Disclosure Policy, as well as standards of the Accreditation Council for Continuing Medical Education (ACCME) and the American Medical Association (AMA), all planners, reviewers, speakers and persons in control of content have been asked to disclose any relationship he /she has with any entity producing, marketing, selling, re-selling, or distributing health care goods or services consumed by, or used on, patients, during the past 24 months. All planners, reviewers and speakers have also been asked to disclose any payments accepted for this lecture from any entity besides Sheppard Pratt, and if there will be discussion of any products, services or off-label uses of product(s) during this presentation.
Elizabeth Fenstermacher, MD, reports that she has no relationships with any entity producing, marketing, selling, re-selling, or distributing health care goods or services consumed by, or used on, patients during the past 24 months. She will not discuss any products, services, or off-label uses in this presentation.
Rachel A. Davis, MD, reports that she is a consultant for Medtronic, Inc. She will also be discussing commercial products with FDA approval for OCD. She will be discussing off-label pharmaceuticals. The content of her presentation has been reviewed to ensure that the information presented is balanced and evidence based.
Event Planners/Reviewers Disclosures: The following event planners and/or reviewers are reported as having no financial interest, arrangement or affiliation with any entity producing, marketing, selling, re-selling, or distributing health care goods or services consumed by, or used on, patients, during the past 24 months: Jon Hershfield, MFT, Todd Peters, MD, Deepak Prabhakar, MD, Elizabeth Ryznar, MD, MSc., Louis Marino, MD, Ehsan Syed, MD, Devi Bhuyan, PhD, Faith Dickerson, PhD, Carrie Etheridge, LCSW-C, Tom Flis, LCPC, Stacey Garnett, RN, MSN, Octavia Coit, MN, Heather Billings, RN, Lisa Illum, MLIS, MEd, and Jennifer Tornabene.
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Psychologist Statement: Sheppard Pratt is authorized by the State Board of Examiners of Psychologists as a sponsor of continuing education. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this continuing education activity. Sheppard Pratt designates this educational activity for a maximum of 1.5 contact hours for Psychologists.
Social Worker Statement: Sheppard Pratt is authorized by the Board of Social Work Examiners of Maryland to offer continuing education for Social Workers. Sheppard Pratt takes responsibility for the content, quality, and scientific integrity of this continuing education activity. This activity is approved for 1.5 contact hours in Category II credits for Social Workers.
Counselor Statement: Sheppard Pratt has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 5098. Programs that do not qualify for NBCC credit are clearly identified. Sheppard Pratt is solely responsible for all aspects of the program. This activity is available for 1.5 NBCC clock hours.
- 1.50 ACEP NBCC clock hours
- 1.50 AMA PRA Category 1 Credit™
- 1.50 Category II credits for Social Workers
- 1.50 Psychologists
- 1.50 MNA Contact Hours for Nurses
- 1.50 Participation
This presentation was originally reviewed on April 10, 2023, and broadcast live online on April 7, 2023, from 2:45PM – 4:15 PM ET.
ON DEMAND WEBINAR: FOR BEST RESULTS WATCH USING GOOGLE CHROME
OCD & Anxiety Lecture Series: Neurosurgery and Other Novel Interventions for Refractory OCD
Rachel A. Davis, MD, DFAPA
Vice Chair, Clinical Affairs and Strategy
Service Director, Psychiatric Neuromodulation and Advanced Therapeutics
Co-Director, OCD Surgical Program
Medical Director, OCD Program
Chief, CUMedicine Outpatient Psychiatry Practices
University of Colorado, Anschutz Medical Campus
Elizabeth Fenstermacher, MD
Assistant Professor of Psychiatry
Medical Director, Transcranial Magnetic Stimulation Service
University of Colorado Anschutz School of Medicine
Originally reviewed April 10, 2023.
Originally broadcast live April 7, 2023, from 2:45- 4:15 PM ET
Enduring Activity Credit Expiration Date: May 12, 2025.
Activity Time: Ninety-minute recorded webinar lecture with a 15-minute evaluation process. Total Time: 1:45
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There is no commercial support for this activity.
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