Obsessive Compulsive Disorder (OCD) impacts around four million people within the United States today, according to Psychiatric Times. Although OCD can cause debilitating impairment to the usual demands of everyday life, some mental illnesses are taken more seriously. This is in part because OCD is widely believed to have effective treatments readily available, while other severe mental illnesses have yet to find effective treatments for the many that are afflicted.
This is not actually the case, however, as OCD is not easily manageable for many treatment-resistant OCD patients. Despite the availability of effective treatments for OCD, up to half of OCD patients do not actually respond to first-line treatments. Additionally, the medication side effects for some are severe enough to negatively affect their quality of life. It’s simply trading one adversity for another and means that some may never experience true remission.
In the past few decades, more research has been dedicating time to understanding precisely what is occurring in the brains of patients with OCD. “One approach has been to target brain chemistry. The thinking is that OCD symptoms result from an imbalance in brain chemicals (or neurotransmitters), which medications such as SRIs can address. And for many individuals, adjusting the brain’s chemistry has been successful in significantly reducing OCD symptoms. But for some, adjusting the brain’s chemistry with medication has not worked (or has not worked all that well),” explains Jeff Szymanski, Ph.D., Executive Director of the International OCD Foundation.
For some, medication may properly address the imbalance in brain chemicals, but others need to try different approaches when it comes to their OCD treatment plan. TMS Therapy is a promising alternative solution—TMS has been shown to target areas of the brain less active in depressed patients, and “reset” the brain, so to speak, causing more brain activity in those areas. This approach may be helpful in adjusting the brain activity of patients with OCD, too.
Does TMS Therapy for OCD Differ?
If you are already familiar with TMS treatment, you may be wondering how the treatment for OCD differs from that of Major Depressive Disorder. As explained by the Clinical TMS Society, while depression can be chronic, include relapses, and/or appear in episodes, OCD rarely has spontaneous remissions. “Even with the best psychotherapies and pharmacotherapies, treatment responses are modest, and a reduction of 30-50% from baseline OCD severity would be a very good response.” In one important TMS trial for OCD, almost 80% showed a measurable positive response. A 30% reduction was considered a good response, with some patients exceeding this, and a 20% reduction was considered partial.
The trial tested patients with 29 treatments, though undergoing more sessions may lead to better results. A minimum of 30 sessions would be ideal to fit the typical TMS Therapy implementation, which consists of five 18-minute sessions a week for six weeks. Treatment could then be extended to 1–2-week intervals if improvements continue.
Another difference in treatments is that the deep TMS H7 coil is used, which targets deeper regions of the anterior cingulated cortex, compared to the figure 8 coil used for patients with depression. Additionally, immediately before TMS treatment for OCD patients, there must be a mild activation of the OCD brain circuits, which usually takes just five minutes. This can consist of simply explaining, thinking about, or looking at images that evoke the patient’s OCD symptoms.
TMS Therapy Eligibility
Patients undergoing TMS Therapy for OCD should be treatment-resistant, but stable on an FDA-approved medication or undergoing maintenance psychotherapy, as TMS is typically conducted in addition to other OCD treatments. Patients with any other severe mental illnesses such as high levels of depression may want to address those conditions first.
The trial tested patients with 29 treatments, though undergoing more sessions may lead to better results. A minimum of 30 sessions would be ideal to fit the typical TMS Therapy implementation, which consists of five 18-minute sessions a week for six weeks. Treatment could then be extended to 1–2-week intervals if improvements continue.
OCD is a mental illness no one should have to live with unaided. If your current treatment plan does not seem to be an effective path for you, TMS may just be the solution that will help improve your quality of life for good. TMS Chesterfield’s precisely targeted NeuroStar Advanced Therapy makes long-term remission possible, which is why it’s the number one choice of doctors. If you’re interested in learning more about TMS Therapy for OCD, please call the TMS Chesterfield office at 636-532-0705, or visit our location today to figure out whether TMS Therapy is a viable alternative for you. At Chesterfield TMS, we know how to make you smile!
