rTMS treatment for OCD (obsessive compulsive disorder)

Dr Lynne Drummond, Consultant Psychiatrist and Senior Lecturer with South West London and St George’s NHS Mental Health Trust, explains more about TMS, Transcranial Magnetic Stimulation, and whether its initial research suggests that it would be a helpful treatment for OCD or not. Harry, who has been treated for his OCD, shares his experience with rTMS at rTMS International.

rTMS for OCD

Dr Lynne Drummond: “A new and novel possibility is the use of TMS. This involves applying powerful magnets to the outside of the skull. By directing these appropriately, it is possible to reduce activity in specific areas of the brain on a temporary basis. Often this is repeated on a regular basis. Regular TMS has been shown to be useful in treating some people with severe migraines and also depression. For depression, TMS is applied daily for a period of up to six weeks.

There is some evidence that TMS can improve symptoms for people with OCD who do not respond to other treatments. However, there are many different approaches to this treatment. There may be some evidence that the type of magnets used need to be more powerful to penetrate deeper in the brain for OCD. Also, the treatments do need to be repeated regularly, but it is unclear as to how long this should be repeated for it to have a lasting benefit.

One of the differences between OCD and depression, is that bouts of depression often last for a defined period of time and are interspersed by periods of remaining well. OCD, however, is often, but not always, a consistent and continuous condition. It may therefore be a problem if a shorter bout of treatment is used. New research is needed to examine not only the efficacy but also the optimal way of delivery TMS to people with OCD. Also, the combination of TMS with the psychological approach of ERP is worthy of further study.”

Experience with rTMS for OCD

Harry: “I was diagnosed with OCD in 2012 after two years of suffering. As a child, I can remember having obsessive thoughts and behaviors, however, the condition did not fully develop until I was in my early twenties. My OCD manifests itself through intrusive thoughts relating to harm to myself and to other that are (very) close to me.

Over the past seven years I have had four failed therapy attempts with different medical professionals at various different levels. I was taking 200mf of Lustral, this reduced my symptoms, however the side effects significantly affected my day-to-day life. At this point my quality of life was extremely poor and to be quite honest miserable.

After browsing the internet of alternative treatments, I came across rTMS (repetitive Transcranial Magnetic Stimulation). After some initial research I found out the treatment was available cheaper in Holland and at this point I had absolutely nothing to lose.

As expected, I was nervous about attending the treatment. After an initial consultation, an EEG which relieved my anxiety, I started the treatment.”

The treatment involves lying on your back on a treatment bed. And electromagnetic coil on a moveable arm is placed up against your head. Prior to each session, your head is marked to ensure the coil is placed in the same place each time. Magnetic pulses are administrated through the coil. The treatment itself is slightly uncomfortable at first however after a few minutes it becomes a mild irritation. It does make you jump at first, but only until you get used to the unusual feeling. In the first minute of the treatment the click makes you close your eye like your face muscles tense slightly.

As the sessions went on, I became more relaxed and eventually ended up laughing and joking with my consultant throughout the sessions. After the first 20 sessions I returned to the UK reducing my medication right away. This was an extremely difficult task, although after sticking with it and reducing gradually over six weeks, I came off medication on a few occasions, all of which failed. I feel that having the treatment significantly increased my chances of successfully coming off my medication. This was my own personal goal, agreed with medical professionals. My discontinuation symptoms subsided after around three months. I then returned for a further 10 sessions.

“I am sure the treatment affects everyone differently.”

I feel the treatment interrupted differently. I feel the treatment interrupted my habitual thinking patterns allowing me to think differently and move away from my traditional, obsessional thoughts. The primary benefit of the treatment was my improved ability to sleep. Prior to the treatment I was sleeping between two – four hours per night. My ability to focus and concentrate has also improved. I feel that the treatment has significantly increased my quality of life.

The treatment itself is not a magic answer, however, it has allowed my brain to move away from my traditional thinking patterns and has allowed me to improve other aspects of my life including sleep, concentration, focus, diet and patience. It’s still very early days, but I feel my treatment has been a success. Many thanks to Bram Wernsen and all at rTMS International. I plan to have further sessions next year to complete my treatment. “

Source: Alternative Treatment Research newsletter