Transcranial Magnetic Stimulation for OCD Treatment

Patient in transcranial magnetic stimulation (TMS) experiment
Monty Rakusen / Getty Images

Although there are currently a number of effective medical and psychological treatments for obsessive-compulsive disorder (OCD), if you have treatment-resistant OCD you may be looking for new ways to treat your symptoms.

Transcranial magnetic stimulation, or TMS, has received considerable attention as a possible alternative treatment to reduce OCD symptoms. Although first developed nearly 30 years ago as a tool to treat major depression, TMS has now been widely investigated for effectiveness in treating a variety of mental illnesses. The two types commonly used for mental illness are repetitive transcranial magnetic stimulation (rTMS) and deep transcranial magnetic stimulation (dTMS).

Repetitive Transcranial Magnetic Stimulation

Repetitive TMS is the predecessor to dTMS and is a relatively non-invasive procedure that involves placing a small device directly on the skull. This sealed device contains a coil of wire that carries electricity through the magnetic field that it generates. It's called repetitive because it pulses rather than remaining steady. The flow of electricity through the device stimulates cells in the brain called neurons, changing their activity levels. The activity level of neurons has been linked to symptoms of mental illness, like OCD. How many rTMS treatments you would need depends on the treatment protocol, and would be discussed by you and your doctor prior to starting your treatment. 

While there have been some reports of rTMS being effective in reducing OCD symptoms, the majority of research findings indicate that rTMS is not effective in reducing OCD symptoms alone or in combination with medication.

Repetitive TMS may indirectly improve the psychological well-being of people coping with OCD by reducing the symptoms of depression that often go along with OCD.

Deep Transcranial Magnetic Stimulation

Like rTMS, deep transcranial magnetic stimulation also uses a coil placed directly on the skull, which creates a magnetic field penetrating the brain. The biggest difference between the two types is that the coil used with dTMS, called an H-coil, allows the pulse to penetrate more deeply into the brain.

Deep TMS is showing a lot of potential over rTMS in treating mental illness. The Food and Drug Administration (FDA) has approved both rTMS and dTMS for the treatment of major depressive disorder and studies are being done on their efficacy for OCD and other mental illnesses, like bipolar disorder, as well.

Deep TMS might have the most to offer in cases where OCD is difficult to treat. One study showed that people with treatment-resistant OCD who received dTMs had significant improvements in their symptoms. The results were steady for three months.

Potential Side Effects

TMS is generally considered safe when used in accordance with established guidelines. After undergoing TMS, you may have headaches, feel sleepy, and experience other mild, short-term symptoms. Epileptic seizures are a more serious, although rare, side effect of rTMS. 

Although TMS for OCD has been looked at in a number of studies, the stimulation parameters used, the brain areas targeted, and the length of treatment has varied from study to study, making it difficult to compare results. While research continues to look at the effect of TMS on OCD, a standard protocol will help researchers determine the effectiveness of rTMS for OCD more conclusively. 

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  1. NIMH. Brain stimulation therapies. Updated June 2016.

  2. Blom RM, Figee M, Vulink N, Denys D. Update on repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: different targetsCurr Psychiatry Rep. 2011;13(4):289–294. doi:10.1007/s11920-011-0205-3

  3. FDA. FDA permits marketing of transcranial magnetic stimulation for treatment of obsessive compulsive disorder. Updated August 17, 2018.

Additional Reading
  • Ruffini, C., Locatelli, M., Lucca, A., Benedetti, F., Insacco, C., Smeraldi, E. "Augmentation effects of repetitive transcranial magnetic stimulation over the orbitofrontal cortex in drug-resistant obsessive-compulsive disorder patients: A controlled investigation. Primary Care Companion to The Journal of Clinical Psychiatry 2009 11: 226-230.
  • Slotema, C.W., Blom, J.D., Hoek, H.W., Sommer, I.E.C. "Should we expand the toolbox of psychiatric treatment methods to include Repetitive transcranial magnetic stimulation (rTMS)? A meta-analysis of the efficacy of rTMS in psychiatric disorders. er, I.E.C. "Should we expand the toolbox of psychiatric treatment methods to include Repetitive transcranial magnetic stimulation (rTMS)? A meta-analysis of the efficacy of rTMS in psychiatric disorders. ​Journal of Clinical Psychiatry 2010 (e-published ahead of print).