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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery
DOI: 10.1055/s-0043-1774747
Case Report

Thermocoagulation in Multiple Targets to Treat Obsessive-Compulsive Disorder Associated with Drug Addiction: Case Report

Termocoagulação de múltiplos alvos para tratar transtorno obsessivo-compulsivo associado à drogadição: relato de caso
Laryssa Simões de Lima Assis 
1   Departamento de Medicina, Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás (PUC-Goiás), Goiânia, GO, Brazil
,
Laura Araújo de Carvalho 
1   Departamento de Medicina, Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás (PUC-Goiás), Goiânia, GO, Brazil
,
Ledismar José da Silva 
1   Departamento de Medicina, Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás (PUC-Goiás), Goiânia, GO, Brazil
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Abstract

Substance-related disorders are chronic psychiatric conditions defined by substance abuse, and they compromise patients both clinically and functionally. Currently, pharmacotherapy, behavioral therapy, or an association of both are the treatments of choice for obsessive-compulsive disorder associated with drug addiction. However, the refractoriness to treatment, as a result of the high failure rates of these approaches, has led to the need to develop surgical techniques to treat severe cases of substance-related disorders. In the present article, we report the case of a patient who underwent neurosurgery through the stereotactic technique after refractoriness to the conventional treatment for drug addiction. The patient showed sustained improvement in his addiction to drugs. Despite the numerous reports on the effectiveness and applicability of neurosurgery in psychiatric disorders, some concerns regarding stereotactic surgery as a treatment for drug addiction still remain, especially in relation to its efficacy, safety, and ethical implications.

Resumo

Transtornos relacionados ao uso de substâncias são condições psiquiátricas crônicas definidas pelo abuso de substâncias, que deixam o paciente comprometido clínica e funcionalmente. Atualmente, a farmacoterapia, a terapia comportamental ou a associação de ambas são os tratamentos de escolha para o transtorno obsessivo-compulsivo associado ao vício em drogas. Contudo, a refratariedade ao tratamento, resultante das altas taxas de fracasso dessas abordagens, tornou necessário o desenvolvimento de técnicas cirúrgicas para tratar casos graves de transtornos relacionados ao uso de substâncias. Neste artigo, relatamos o caso de um paciente submetido a neurocirurgia pela técnica estereotáxica após fracasso do tratamento convencional para drogadição. O paciente apresentou melhora sustentada do vício em drogas. Apesar dos inúmeros relatos sobre a eficácia e a aplicabilidade da neurocirurgia em transtornos psiquiátricas, ainda existem certa preocupação a respeito da cirurgia estereotáxica como tratamento para a drogadição, principalmente em relação à sua eficácia, segurança e implicações éticas.

Keywords

obsessive compulsive disorder - drug addiction - thermocoagulation - case report

Palavras-chave

transtorno obsessivo-compulsivo - dependência de drogas - termocoagulação - relato de caso


Publication History

Received: 22 November 2021

Accepted: 07 March 2023

Article published online:
18 October 2023

© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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