Fulfilling the need for effective solutions in managing obsessive-compulsive disorder (OCD) poses a significant challenge. Despite the established role of medication and therapy in symptom management, many individuals still grapple with limited relief. However, emerging techniques such as transcranial magnetic stimulation (TMS) and repetitive TMS (rTMS) offer a glimpse of promise. These non-invasive brain stimulation methods are gaining recognition as potential adjuncts to traditional treatments, opening up new pathways for those seeking additional support in their struggle against OCD, major depressive disorder, and other mental health disorders.
What is Obsessive Compulsive Disorder (OCD)?
Obsessive-compulsive disorder (OCD) is a psychiatric condition affecting about 2-3% of the population, characterized by persistent and intrusive thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions). These symptoms significantly impair daily functioning and quality of life.
Common obsessions include fear of contamination, harm to oneself or others, and thoughts about symmetry or order, while compulsions often manifest as repetitive behaviors like excessive hand washing, checking, or counting. Individuals with OCD feel compelled to perform these actions to alleviate anxiety or prevent feared events. Yet, these compulsions are often time-consuming and provide only temporary relief from distress [8].
Related: Exploring the Types of OCD: A Guide to Obsessive-Compulsive Variations
How TMS Therapy Works for OCD
Transcranial Magnetic Stimulation (TMS) therapy for OCD works by targeting specific areas of the brain associated with OCD symptoms. It is a non-invasive treatment that involves applying magnetic pulses to these regions to disrupt abnormal brain activity linked to OCD and promote more balanced neural functioning [2].
This therapy primarily focuses on key brain regions, such as the dorsolateral prefrontal cortex (DLPFC), supplementary motor area (SMA), and orbitofrontal cortex (OFC), which are involved in regulating thoughts and behaviors [2].
By repeatedly stimulating these areas, TMS aims to modulate neural circuits related to OCD, potentially reducing the frequency and intensity of intrusive thoughts and compulsive behaviors. It provides a non-invasive alternative to traditional treatments like medication and psychotherapy, offering hope for individuals who may not respond well to other interventions. Ongoing research aims to refine TMS techniques and treatment protocols to improve outcomes for individuals with OCD [2].
What Does the Research Say?
Research into the effectiveness of TMS for OCD has yielded promising results, with studies indicating a significant reduction in symptoms for a substantial percentage of patients. According to data from the OCD Foundation, between 45% to over 55% of patients have experienced diminished OCD symptoms following TMS treatment, with some individuals requiring maintenance sessions post-initial treatment [5].
Studies focusing on repetitive TMS (rTMS) have shown its potential as a viable treatment option for OCD, with specific stimulation protocols demonstrating effectiveness in improving symptoms. For instance, a study involving 41 OCD patients found that high-frequency (HF) stimulation over certain brain regions led to significant symptom improvement compared to low-frequency (LF) stimulation [6].
Retrospective analyses further support the efficacy of TMS therapy for OCD, showcasing reductions in symptom severity among patients with OCD-related disorders. Ongoing research endeavors seek to deepen our understanding of TMS mechanisms for OCD and refine treatment protocols [3].
In studies exploring deep transcranial magnetic stimulation (dTMS), researchers have found significantly better improvement in OCD symptoms for patients receiving real dTMS compared to sham treatments, suggesting a promising option for individuals who have not found relief with other treatments [1].
Ongoing research continues to explore the efficacy of targeting diverse brain areas and utilizing various stimulation frequencies to enhance statistical power and address variability in patient characteristics and stimulation protocols [3, 5, 6].
Other Treatments that TMS therapy will Complement
TMS therapy is often used as a complementary treatment for OCD, meaning it may be used alongside other treatments such as selective serotonin reuptake inhibitors and other medications, cognitive-behavioral therapy (CBT), or exposure and response prevention (ERP) therapy. By integrating TMS with other therapies, clinicians aim to offer a more comprehensive and personalized treatment approach for individuals with OCD, potentially leading to improved outcomes in managing symptoms.
According to the National OCD Foundation, combining TMS with CBT may enhance treatment outcomes by targeting both neural circuits and cognitive processes associated with OCD. Additionally, TMS therapy may offer an alternative or adjunctive treatment for patients who do not respond adequately to traditional treatments, such as medication [5].
Does TMS Work for OCD?
Research on the success rate of TMS for OCD has shown promising results. Several studies have reported the following success rates:
A peer-reviewed multicenter clinical study found that about 45% of patients experienced reduced OCD symptoms at one month following treatment [5].
In a peer-reviewed multicenter clinical study, it was found that over 1 in 3 patients with treatment-resistant OCD experienced a reduction of more than 30% in their OCD severity rating after undergoing deep TMS therapy. This significant improvement in OCD symptoms greatly enhanced their quality of life [9].
Moreover, a post-marketing study involving over 200 patients published in the Journal of Psychiatric Research demonstrated even more encouraging results. Roughly 60% of patients achieved a reduction in their OCD severity rating of more than 30% through deep TMS therapy. Almost 90% of patients maintained their treatment response for more than 1 year. These findings highlight the sustained effectiveness of deep TMS in real-life clinical practice settings [9].
These studies offer strong evidence supporting TMS as an effective treatment option for OCD, particularly for patients who have not responded well to traditional therapies.
What is the Best Therapy for OCD?
The best way to treat OCD usually involves a mix of talking therapy and medication. One type of talking therapy called CBT, especially a part of it called Exposure and Response Prevention (ERP), can be beneficial. ERP is about gradually facing the things that make you anxious without doing your usual rituals. This helps you learn better ways to deal with your worries [7].
Medication, like certain antidepressants, is also common. These drugs can help control the obsessions and compulsions of OCD. But finding the right one might take some time, and there could be side effects. If traditional treatments don’t work, there are other options, like intensive therapy programs or brain stimulation techniques. It’s important to talk with your doctor to determine what’s best for you [7].
For some individuals, transcranial magnetic stimulation (TMS) or repetitive TMS (rTMS) can serve as an additional treatment option or complementary therapy, especially for those who have not responded well to traditional treatments like medication or therapy alone. These brain stimulation techniques are being researched as potential adjuncts to existing treatments for OCD, offering new possibilities for symptom management.
Related: OCD Treatments: Which is Best and Which is Right For You?
Is TMS for OCD Covered by Insurance?
Insurance coverage for Transcranial Magnetic Stimulation (TMS) therapy for OCD can vary. Whether TMS for OCD is covered by insurance depends on several factors, including the individual’s specific health insurance plan, OCD symptom severity, and the requirements set forth by their insurance provider.
Some insurance companies may require individuals to undergo prior authorization before starting TMS treatment for OCD. Additionally, they may stipulate that individuals attempt other forms of OCD treatment before TMS.
The location of the treatment provider may also influence coverage. Certain regions or healthcare facilities may have different agreements with insurance companies regarding TMS coverage for OCD.
Individuals should contact their insurance carrier or healthcare provider directly to determine whether TMS for OCD is covered by their insurance. It’s important for individuals to understand the specifics of their coverage, including any potential out-of-pocket costs associated with TMS therapy for OCD. Our care team at Neuro Wellness Spa is always available to walk you through insurance coverage and answer any questions you might have.
Does TMS Get Rid of Intrusive Thoughts?
Transcranial Magnetic Stimulation (TMS) is a treatment method that holds promise in addressing intrusive thoughts associated with conditions like OCD. While TMS doesn’t necessarily eliminate intrusive thoughts altogether, it can help individuals manage them more effectively [4].
The treatment works by targeting specific areas of the brain associated with OCD symptoms, essentially modulating brain activity. By stimulating these areas, TMS can enhance cognitive control, making it easier for individuals to resist compulsions and ignore intrusive thoughts. Therefore, while TMS may not completely eradicate intrusive thoughts, it can significantly reduce their impact and frequency, leading to improved quality of life for individuals with OCD [4].
Treating OCD
Transcranial magnetic stimulation (TMS) provides an additional avenue for individuals struggling with OCD, offering another viable option for symptom management. As ongoing research progresses, TMS stands as a pragmatic alternative for those who have not responded to traditional treatments alone.
Are you or someone you know struggling with OCD? Don’t let OCD hold you back any longer. Take the first step towards reclaiming your mental wellness by contacting us today. At Neuro Wellness Spa, we specialize in providing comprehensive OCD treatments that suit your specific needs. Reach out to discuss whether any of our treatment options may be appropriate for you.
Your journey to a healthier mind starts now. Reach out to schedule a consultation with one of our mental health experts and learn more about your treatment options including in-person and online psychiatry for medication management, integrative brief psychotherapy utilizing modalities that are effective for treating and managing OCD, and TMS therapy which stimulates parts of the brain that have been negatively impacted by OCD. Call us today and take the first step towards a brighter future.
References
- Carmi, L., Tendler, A., Bystritsky, A., Hollander, E., Blumberger, D. M., Daskalakis, J., Ward, H., Lapidus, K., Goodman, W., Casuto, L., Feifel, D., Barnea-Ygael, N., Roth, Y., Zangen, A., & Zohar, J. (2019). Efficacy and Safety of Deep Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder: A Prospective Multicenter Randomized Double-Blind Placebo-Controlled Trial. The American journal of psychiatry, 176(11), 931–938. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2019.18101180
- Cocchi, L., Zalesky, A., Nott, Z., Whybird, G., Fitzgerald, P. B., & Breakspear, M. (2018). Transcranial magnetic stimulation in obsessive-compulsive disorder: A focus on network mechanisms and state dependence. NeuroImage. Clinical, 19, 661–674. https://doi.org/10.1016/j.nicl.2018.05.029
- Di Ponzio, M., Makris, N., Tenerini, C., Grassi, E., Ragone, S., & Pallanti, S. (2023). rTMS investigation of resistant Obsessive-Compulsive Related Disorders: Efficacy of targeting the reward system. Frontiers in psychiatry, 13, 1035469. https://doi.org/10.3389/fpsyt.2022.1035469
- Drakulich, A. (2022, March 16). OCD and Deep TMS: Practical Applications. MedCentral. https://www.medcentral.com/behavioral-mental/ocd/deep-tms
- International OCD Foundation (n.d.). Transcranial Magnetic Stimulation (TMS) for OCD. https://iocdf.org/about-ocd/treatment/tms/
- Lusicic, A., Schruers, K. R., Pallanti, S., & Castle, D. J. (2018). Transcranial magnetic stimulation in the treatment of obsessive-compulsive disorder: current perspectives. Neuropsychiatric disease and treatment, 14, 1721–1736. https://doi.org/10.2147/NDT.S121140
- Mayo Clinic (2023, December 21). Obsessive-Compulsive Disorder (OCD). https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/drc-20354438
- Roth, Y., Tendler, A., Arikan, M. K., Vidrine, R., Kent, D., Muir, O., MacMillan, C., Casuto, L., Grammer, G., Sauve, W., Tolin, K., Harvey, S., Borst, M., Rifkin, R., Sheth, M., Cornejo, B., Rodriguez, R., Shakir, S., Porter, T., Kim, D., … Zangen, A. (2021). Real-world efficacy of deep TMS for obsessive-compulsive disorder: Post-marketing data collected from twenty-two clinical sites. Journal of psychiatric research, 137, 667–672. https://doi.org/10.1016/j.jpsychires.2020.11.009
- Tendler, A., & Blackman, S. (2023, April 11). Achieving OCD Relief: Consideration of TMS Earlier in the Treatment Continuum. https://www.psychiatrictimes.com/view/achieving-ocd-relief-consideration-of-tms-earlier-in-the-treatment-continuum