Brain Capsulotomies Not Risk Free

Treating patients with obsessive compulsive disorders (OCD) by giving them a capsulotomy is very high risk and should be considered an absolute last resort, according to a study by the Karolinska Institute in Sweden.

A capsulotomy is an operation where part of the internal capsule in the brain’s frontal lobe is destroyed.

It was first used in France in the 1940’s and has been used in Sweden for decades to treat depression, schizophrenia and obsessive compulsive disorders. It was used when other treatment such as drugs and psychotherapy didn’t help. But although half the patients improve afterwards, the risks are high.

Karolinska Institute’s Senior Physician Christian Rück already ascertained in 2003 that capsulotomies were not risk free, with 7 out of 26 patients reacting negatively.

Now Rück’s research team has studied a further 25 patients with OCD who were operated on between 1988-2000. They were followed up and the results indicate that capsulotomies’ risks have been underestimated.

35 percent certainly show improvement, but at least as many have had severe side effects such as apathy, lack of inhibition, incontinence and weight gain.

Speaking to Swedish Radio, Rück described capsulotomies as more high risk than they have been regarded so far. 

Around 200-300 Swedes have undergone the operation so far.

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