TMS for OCD: Does It Work?

Transcranial magnetic stimulation (TMS) uses magnetic fields to stimulate specific areas of the brain. It’s shown promise in treating obsessive-compulsive disorder (OCD), including cases that may not respond to other treatments.

Obsessive-compulsive disorder (OCD) is a chronic mental health condition. Although it’s usually treated through talk therapy and medication, other treatments — including transcranial magnetic stimulation (TMS) — may also be effective.

What is TMS?

Transcranial magnetic stimulation is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain.

The therapy involves placing an electromagnetic coil against your scalp near your forehead. The coil generates magnetic pulses that can modulate the activity of specific brain regions. The regions it stimulates depend on the condition you’re treating.

In 2018, the Food and Drug Administration approved TMS as a treatment for OCD , particularly for symptoms that haven’t responded to medication and psychotherapy.

TMS protocols for OCD often target the prefrontal cortex, an area of the brain linked to mood regulation and anxiety.

Different devices and methods for administering TMS exist, including repetitive TMS (rTMS) and deep TMS (dTMS), which penetrate deeper into the brain tissues.

TMS isn’t only used to treat OCD, though. Medical professionals also use it to treat depression, anxiety disorders, post-traumatic stress disorder (PTSD), and other mental health conditions.

Is TMS effective and safe for treating OCD?

TMS is considered a safe treatment, and a fair amount of evidence suggests it can help with the symptoms of OCD.

A 2020 study found that TMS effectively improves symptoms of OCD, even in people who did not experience changes after trying medication and cognitive behavioral therapy (CBT) , a type of talk therapy often used in OCD.

A 2021 research review also suggests that TMS, especially low-frequency, is effective for treating OCD symptoms. TMS that focuses on the dorsolateral prefrontal cortex (in the upper forehead area) and supplementary motor area (top of the head) seems to yield satisfactory results.

The researchers also concluded that TMS is generally well-tolerated, meaning the side effects, when they happened, were mild and manageable. A 2023 research review reached a similar conclusion.

One major challenge with studies on TMS for OCD is the lack of consensus on which areas of the brain to target, which treatments to use alongside TMS, and the duration and number of sessions. Further research should help clarify this.

What to expect during a TMS session

You will work with a technician or general physician specialized in this therapy. You won’t need to stay overnight in a hospital after your treatment, and you will be awake during the entire session.

A TMS session may involve the following steps:

1. You will sit in a comfortable chair and may wear earplugs. These will help with the loud clicking sounds associated with TMS.
2. The TMS technician or doctor will place an electromagnetic coil on your scalp.
3. The coil will deliver magnetic pulses to the targeted brain area. You might hear clicking sounds and feel a tapping sensation on your scalp. TMS is painless.

Each TMS session usually lasts 20 to 60 minutes, but the total number of TMS sessions for OCD may vary. Usually, you’ll need sessions several times a week for about 4 to 6 weeks.

Some people with OCD may notice symptom improvement within the first few weeks of treatment.

Does TMS for OCD have side effects?

TMS is generally well-tolerated, but you may experience side effects. These can include:

• changes in cognitive function (your ability to think)
• confusion during the treatment
• facial twitching
• headaches
• lightheadedness
• neck pain
• scalp pain or itching

Most TMS side effects resolve on their own after the first few sessions. Over-the-counter pain medications can usually help with headaches and neck pain.

You can discuss any side effects and your options with the TMS technician or your doctor.

According to research, there’s a 0.1% chance of experiencing seizures during a TMS course.

Consider discussing any concerns with a healthcare professional before starting TMS therapy.

Is TMS used with other OCD therapies?

Yes, TMS is often used at the same time as other OCD treatments.

Combining TMS with psychotherapy and medication can address both the psychological and physiological aspects of OCD.

According to a 2023 review of research , there isn’t yet a clear consensus on the best protocol for treating OCD with TMS. This means that clinicians have not yet determined which treatments are most effective when combined with TMS.

Is TMS for everyone with OCD?

Although it’s considered a safe procedure, TMS may not be suitable for everyone with OCD.

Usually, TMS is recommended for people who have OCD symptoms that haven’t responded to other treatments, like medication and therapy.

A doctor may not recommend TMS for OCD if you have certain medical conditions or if you:

• use stimulant medications
• have a history of seizures
• have metal implants in or near the head (but you can get TMS if you have braces or dental fillings)

TMS hasn’t been tested in people who are pregnant.

If you’re not sure if you would benefit from TMS, you may want to speak with a healthcare professional other than the TMS technician.

Takeaway

TMS is a promising treatment for OCD, especially for people who haven’t had symptom relief with conventional OCD treatments like talk therapy and medication.

TMS is both noninvasive and safe and has been shown to be effective in reducing OCD symptoms and improving quality of life.

If you’re considering TMS for OCD, a healthcare professional trained in TMS can help. They will work with you to determine if this treatment is appropriate for you.

You may also want to look into other alternative OCD treatments, like deep brain stimulation, psychedelic-assisted therapy , and mindfulness-based interventions.