OCD is a debilitating but treatable condition through therapy, medications, or TMS (transcranial magnetic stimulation). TMS was first developed in 1985 for treating depression but over the years the applications have been widened to many other disorders. In 2018, the FDA cleared TMS for OCD and it has been found to be a powerful, non-invasive approach to treat OCD. In this article, we will discuss how TMS for OCD works, who are candidates for this treatment, how to get insurance coverage for TMS for OCD, what the treatment for OCD entails, and why A Better Day Psychiatry is where you should choose to receive this treatment.
What is OCD and How is it Treated?
The term OCD is often misused to describe someone who is overly organized, meticulous, or perfectionistic. In reality, OCD is a debilitating condition marked by persistent, recurrent, unwanted thoughts followed by repetitive behaviors (checking things an inordinate number of times, hand washing, etc.) or mental acts (counting, following a ritual, etc.). These obsessions and compulsions cause marked distress, can be incredibly time consuming, and impair one’s ability to function in daily life. Globally, OCD impacts 1-3% of the population through their lifetime and there is a high comorbidity with anxiety and depression. OCD can be difficult to treat and often involves the combination of medication management and exposure and response prevention therapy. Other modalities include deep brain stimulation (where an implantable electric device is surgically placed in the brain) or electroconvulsive therapy (which involves anesthesia and the induction of seizures to treat OCD). For individuals who have not responded to the traditional treatments of medications and therapy, have not tolerated the medications, and who want a non-invasive, safe, and effective treatment option, TMS may be the treatment of choice for addressing OCD.
What Is TMS Therapy and How Does It Work?
TMS therapy is a treatment that is done in an outpatient setting where magnetic pulses induce electrical changes in the neurons in the regions of the brain that affect mood, anxiety, and OCD. TMS therapy is highly effective, safe, well tolerated, and non-invasive. Though it is a less commonly discussed and understood intervention, TMS is backed by thorough research and is a powerful tool used by psychiatrists to address difficult to treat conditions such as major depressive disorder, anxiety, and OCD.
Is TMS FDA Approved for OCD?
TMS received FDA clearance for OCD in 2018. This FDA clearance speaks to the safety, efficacy, and depth of research that supports the use of TMS for OCD.
Who Is a Good Candidate for TMS Therapy for OCD?
To be a good candidate for TMS for OCD, you need a formal OCD diagnosis by a mental health professional and to have moderate to severe symptoms. You must be 18 years or older and be able to commit to 6-7 weeks of daily (5 days per week) of treatment, though the treatments are often under 30 minutes. Contraindications to TMS include having ferromagnetic devices or implants near the head or a history of seizures or epilepsy.
What to Expect From OCD-Focused TMS Treatment
Once you begin TMS therapy for OCD, the first step after consulting with a psychiatrist is the mapping session. In this session, a psychiatrist will deliver pulses to the brain to stimulate a muscle twitch in one or both of your big toes. This muscle twitch helps locate the precise location that the TMS therapy will be delivered to, which in the case of OCD is the medial prefrontal cortex or anterior cingulate cortex. After the mapping is complete, you will then proceed to have around 36 sessions over the course of 6-7 weeks (5-days per week). The sessions last roughly 30-minutes. Unique to TMS therapy for OCD, prior to the sessions you will engage in a “provocation” exercise where you will provoke obsessive thoughts that cause a moderate degree of discomfort for 5 minutes before the treatment. This activates the specific circuits of the brain related to OCD symptoms and facilitates neuroplastic changes in these brain regions.
TMS for OCD Results: What the Research Shows
Studies looking at TMS for OCD response rates (at least a 30% reduction in symptoms) range from around 35-55% in populations who have treatment resistant OCD. TMS for OCD remission rates (no longer meeting diagnostic criteria for OCD) range from 16-30% in studies. Although these rates may seem low, these are treatment resistant populations who have not responded to other interventions and who can experience profound relief from TMS.
Insurance and Cost: What You Should Know
If you are looking to pursue TMS for OCD, then a great first step may be to see if it will be covered by insurance. For insurance to cover or partially cover your treatment, you typically need to have moderate to severe symptoms, have failed at least two medications, and tried an evidence-based therapy for OCD but are still having significant impairment from OCD. In cases when insurance does not cover OCD, see our TMS therapy cost page.
Why Choose A Better Day Psychiatry for TMS in Golden?
Ready to explore TMS for OCD as a treatment option? Contact A Better Day Psychiatry in Golden to schedule your initial consultation and see if TMS is right for you. We deliver evidence based, personalized treatment to allow you to better enjoy your life.