OBJECTIVE: Smoking and overeating are compulsory habits that are difficult to stop. Several studies have shown involvement of the nucleus accumbens in these and other addictive behaviors. In this case report, we describe a patient who quit smoking and lost weight without any effort, and we review the underlying mechanisms of action.
CLINICAL PRESENTATION: A 47-year-old woman presented with chronic treatment-refractory obsessive-compulsive disorder, nicotine dependence, and obesity.
INTERVENTION: The patient was treated with deep brain stimulation of the nucleus accumbens for obsessive-compulsive disorder. Unintended, effortless, and simultaneous smoking cessation and weight loss were observed.
CONCLUSION: This study supports the idea of compulsivity with common circuitry in the processing of diverse rewards and suggests that deep brain stimulation of the nucleus accumbens could be a possible treatment of patients with a dependency not responding to currently available treatments.
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (Mantione) (van de Brink) (Denys)
Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands (van de Brink)
Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (Schuurman)
Reprint requests: Damiaan Denys, MD, PhD, Academic Medical Center, University of Amsterdam, PA.2-179, PO Box 75867, 1070 AW Amsterdam, The Netherlands. Email: firstname.lastname@example.org
Received, December 11, 2008.
Accepted, August 17, 2009.