Comorbidity of OCD with MDD (OCD-MDD) is a challenging psychiatric condition.

Current available treatments for OCD-MDD are of limited efficacy.

Repetitive transcranial magnetic stimulation (rTMS) is efficacious for treatment of OCD-MDD.

Right orbitofrontal rTMS augmentation is safe and may be effective for treatment of OCD-MDD.

We examined the safety and efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) of the right orbitofrontal cortex (OFC) in patients with refractory obsessive-compulsive disorder (OCD) and comorbid Major Depressive Disorder. All participants (n = 26) received excitatory stimulation of the left dorsolateral prefrontal cortex followed by inhibitory stimulation of bilateral supplementary motor area for 10 sessions. In 18 patients with poor early OCD response, treatment was augmented with OFC inhibitory stimulation after the tenth treatment session. Augmentation with OFC stimulation was well-tolerated, and associated with further alleviation of both OCD and depression symptoms, particularly in individuals with more severe illnesses.

Comorbid OCD-MDD

rTMS

Orbitofrontal cortex

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