Is Transcranial Magnetic Stimulation an Effective OCD Treatment?

Repetitive TMS and Deep TMS May Help OCD Symptoms

Scientist conducting transcranial magnetic stimulation (TMS) experiment on patient
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Although there are currently a number of effective medical and psychological treatments for obsessive-compulsive disorder (OCD), these treatments don't work for everyone. As such, there has been great interest in developing new OCD treatments or using new methods to improve the effectiveness of existing treatments. Transcranial magnetic stimulation, or TMS, has received considerable attention as a possible alternative treatment to reduce OCD symptoms.

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. The number of treatments given depends on the treatment protocol.

Deep Transcranial Magnetic Stimulation

Like rTMS, deep transcranial magnetic stimulation also uses a coil that is placed directly on the skull and that creates a magnetic field that penetrates 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 as well.

Potential Side Effects of TMS

TMS is generally considered safe when used in accordance with established guidelines, although some patients report experiencing headaches, sleepiness and other mild symptoms that are generally short-term. Epileptic seizure is a more serious, although rare, side effect of rTMS. 

Transcranial Magnetic Stimulation and OCD

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, including OCD.

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 either alone or in combination with medication. There is, however, some indication that rTMS could indirectly improve the psychological well-being of people coping with OCD by reducing the symptoms of depression that often go along with OCD.

One recent study showed that dTMS resulted in significant improvement for people with treatment-resistant OCD, and the results were steady for three months, so it is possible that dTMS is a better option for OCD than rTMS.


Further Studies are Needed on TMS for OCD

Clearly, more research is needed. Specifically, there is a need to standardize the treatment of OCD with TMS. 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. Having a standard protocol will allow the effectiveness of rTMS for OCD to be evaluated more conclusively. 


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. Journal of Clinical Psychiatry 2010 (e-published ahead of print).

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