TMS Therapy For OCD

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Obsessive-compulsive disorder (OCD) is a common mental and behavioral disorder that affects approximately four million people of all ages in the US.

Research suggests that half of those with OCD do not respond to traditional treatments. Despite this and the challenging adverse effects of pharmacological treatment, options are limited for safe and effective therapy in reducing OCD symptoms.

Transcranial magnetic stimulation (TMS), a Food and Drug Administration (FDA) approved treatment, has recently been shown to alleviate symptoms of OCD.

Due to its accessibility and noted effectiveness in obsessive-compulsive disorder treatment, people with the disorder have started to show greater interest in TMS and the benefits it could have on their life.

At GIA Miami, we offer TMS therapy for OCD and other mental health disorders. Read here to find out more about TMS therapy for OCD.

TMS Therapy for OCD Treatment

Transcranial magnetic stimulation has been used to treat various mental health disorders; it is especially effective in treating major depressive disorder. Recently, researchers have developed a TMS treatment targeting specific areas of the brain affected by OCD and have found a decrease in OCD symptoms after treatment.

TMS generally describes a few techniques and technologies that utilize magnetic waves to stimulate activity in the brain. TMS treatment for OCD consists of two different devices:

Repetitive transcranial magnetic stimulation (rTMS)
Deep transcranial magnetic stimulation (dTMS)

The only difference between these two devices is that the design of the coil used in dTMS allows pulses to reach deeper into the brain, targeting areas that a standard rTMS device cannot reach.

The coil then generates magnetic pulses directed to specific parts of the brain. For example, rTMS can target the dorsolateral prefrontal cortex, pre-supplementary motor area, and the dorsomedial prefrontal cortex, effectively reducing OCD symptoms.

Similarly, deep transcranial magnetic stimulation can be used to target the anterior cingulate cortex, also creating positive effects. The combination of these TMS treatments and a dTMS device has been cleared by the FDA as an OCD treatment.

Deep TMS therapy for OCD is localized and precisely targets the medial prefrontal cortex and the anterior cingulate cortex - both essential in regulating OCD symptoms.

The Yale brown obsessive-compulsive scale is a scale used to measure OCD symptom severity. A 2019 clinical trial used this to show that repetitive transcranial magnetic stimulation significantly reduced OCD symptoms after a course of treatment.

The trial showed a significant 30% reduction in symptom severity after six weeks of daily deep TMS therapy. After 10 weeks, 38.1% of clients showed a positive response compared to only 11.1% who were in the sham group.

Those who are treatment-resistant now have an alternative option for treatment for OCD. These treatments are specifically administered to those who have tried first-line treatments and still struggle with OCD symptoms.

To increase the effectiveness of treatment, at GIA Miami, we provide TMS therapy alongside other treatment options such as ERP or medication.

What Is Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder is a mental health disorder that causes anxiety-inducing thoughts and behavior. People with OCD experience obsessions and compulsions that can cause significant distress and are incredibly time-consuming.

Obsessions. These are intrusive, repetitive, and distressing thoughts or urges outside of a person's control.
Compulsive behavior. People with OCD develop certain ritualistic behaviors or actions as a way to conceal the anxiety associated with obsessive thoughts.

Although compulsive behaviors are initially created to reduce anxiety, they quickly become a part of a person's obsessive OCD symptoms and encourage anxious thought patterns.

Generally, many of us do experience distressing thoughts from time to time. However, they do not disrupt our everyday lives. For those with obsessive-compulsive disorder, thoughts are constant, and behaviors are rigid - failure to perform these causes great stress.

Causes of OCD

Although there is no set reason why a person develops obsessive-compulsive disorder, there are a number of factors that may increase the risk of developing or triggering the condition.

OCD may have a genetic component; therefore, if OCD is prevalent in the family, a person is at higher risk. A stressful or traumatic event may also trigger negative thoughts and behavior patterns.

Those with OCD have often been found to have co-occurring mental health disorders. Three in four people have been reported to have a history of anxiety disorders, and an estimated one in two have also been diagnosed with major depressive disorder.

OCD Symptoms

Common obsessions that affect people with an obsessive-compulsive disorder include:

Fear of contamination
A need for orderliness
Fear of harming themselves or others by mistake
Distressing and unwanted thoughts

A majority of those with OCD are aware that their compulsive behaviors do not logically make sense, but they cannot stop acting on their thoughts. Types of compulsive behaviors include:

Obsessive cleaning and hand washing
Over-checking locks on doors or that things are switched off
Counting
Arranging and ordering things
Repeating specific actions or words

Diagnosis of OCD

It can be difficult to diagnose OCD as symptoms are similar to those experienced by people with depression, anxiety, and other mental health disorders. Additionally, it is also possible to have co-occurring mental illnesses - the presence of two or more disorders.

A typical OCD diagnosis is given by a psychiatrist and starts with a psychological evaluation. This involves discussing thoughts, behaviors, and symptoms that may interfere with everyday life.

The Diagnostic and Statistical Manual of Mental Disorders (5th edition) covers a criterion that specifies OCD symptoms as different from persistent negative thoughts or delusions that can typically be associated with another mental illness.

The specific OCD section in the DSM-5 also covers related disorders such as:

Body dysmorphia
Hoarding disorder
Skin picking
Substance/medication-induced OCD

These were grouped together as they are considered related disorders due to genetic, phenotypic, neuroimaging, and treatment response data.

Current OCD Treatments

There are many different forms of OCD treatment that have been proven effective through research studies and clinical trials that have been widely used for over 30 years.

Treating OCD involves reducing symptoms and guiding clients in dealing with induced anxiety. Two particular types of cognitive-behavioral therapy (CBT) called exposure and response prevention (ERP) and selective serotonin reuptake inhibitors (SSRIs) are both effective means for first-line treatments for obsessive-compulsive disorder.

Exposure and Response Prevention

CBT is a form of psychotherapy that can treat a range of mental health disorders. With the support of a mental health professional, ERP involves exposure to specific things that create fears and anxieties.

This has been found to reduce negative thoughts surrounding various triggers that induce OCD symptoms.

Serotonin Reuptake Inhibitors (SSRI)

Pharmacological treatment has also been proven to be effective in reducing OCD symptoms. SSRIs are typically the first option for people with OCD and are effective in 50% to 70% of people. However, as they are not localized, they can create adverse and challenging side effects.

Additionally, a larger quantity of SSRIs than those used to treat depression are needed in order for them to be effective. But increasing intake of SSRIs can have serious negative consequences, which have led those with OCD to stop taking medication.

Medical professionals also don't really know how SSRIs work in the brain when reducing symptoms. Therefore, it is difficult to predict whether a client's response will be positive or negative when offered the drug.

Some people with severe OCD are first-line treatment-resistant and, until recently, alternative options have been limited. Fortunately, over the past 10 years, transcranial magnetic stimulation (TMS) has emerged, offering a new lifeline for those living with the disorder.

Related: TMS Therapy for PTSD

What Is TMS for OCD?

Transcranial magnetic stimulation is a non-invasive treatment that stimulates activity in brain regions associated with OCD through magnetic fields.

TMS treatment, which has FDA clearance, is administered by a medical professional in a clinical setting. The TMS device is placed on the head, and a wire coil then sends electric currents through the coil to generate a magnetic field.

This passes through the TMS device and into the brain to target specific areas. Those undergoing TMS treatment remain awake throughout the procedure, and discomfort is minimal. During the procedure, it is common to feel a slight tapping on the side of the head. However, this diminishes with each session.

FDA-Approved TMS Devices

There are currently two FDA-approved devices that are in use for TMS therapy for OCD.

The first is the BrainsWay deep transcranial magnetic stimulation. This was approved in 2018 and uses a specific patented H7 coil that is effective in reducing OCD symptoms. This sits inside a cushioned helmet that is then placed on the head.

In 2020 the FDA cleared MagVenture, which uses a cool dB80 coil device.

Side Effects of TMS

Transcranial magnetic stimulation is a non-invasive treatment that has minimal side effects. Clients have reported only mild discomfort that alleviates quickly. However, there are a number of common side effects that can be expected after treatment, such as:

Headaches
Scalp discomfort
Lightheadedness

There is a very slight (less than 1%) risk of seizure, and we carefully assess our clients beforehand to make treatment as safe as possible.

What Happens During a Transcranial Magnetic Stimulation Session?

As mentioned, transcranial magnetic stimulation therapy is administered in a medical setting. Typically a course lasts for four to six weeks, with sessions completed five days a week.

In the first part of each session, there is a provoking period where an attempt is made to trigger OCD symptoms. This helps engage the specific circuit that will be targeted during treatment. An 18 minute TMS treatment follows this.

Clients sit with the TMS device attached to their heads during each treatment, and earplugs are worn to mute the tapping sound. Once the treatment is finished, you can continue with your day.

TMS for OCD Treatment With GIA Miami

At GIA Miami, we know that OCD can interfere with a person's life, and it has a trickle-down effect and seeps into aspects of daily life. Following our treatment, we believe that all of our clients will be able to live a healthy and fulfilling life.

We understand the uniqueness of OCD and OCD symptoms differs for everyone, which is why we offer each of our clients a personalized treatment program that suits their needs.

In addition, we provide a range of effective outpatient treatment programs, allowing us to support each individual throughout recovery without disrupting everyday life. Treatments include:

Transcranial magnetic stimulation (TMS)
Cognitive-behavioral therapy (CBT)
Support groups
Family therapy
Psychiatric services
Functional medicine

Contact Us Today

If you would like to find out more about TMS therapy for OCD, our team of world experts is on hand to answer any questions you may have.

Likewise, if you are ready to get started on treatment, we are here to support you on your recovery journey to sustain a happy and healthy life. If you are ready to work towards recovery, we are more than happy to discuss possible treatment options.