Obsessive-Compulsive Disorder (OCD)
What is OCD?
Obsessive-Compulsive Disorder, or OCD, is a mental health condition that causes persistent, unwanted thoughts, fears, or urges called obsessions. These thoughts can feel intrusive and overwhelming, often creating intense anxiety or distress.
In response, a person may feel driven to perform repetitive behaviors or mental rituals, known as compulsions, in an effort to relieve that anxiety or prevent something bad from happening. OCD is much more than simply being neat or organized. It can interfere with work, relationships, sleep, and daily peace of mind.
At Bella Vida TMS, we understand how exhausting and isolating OCD can feel. Patients choose Bella Vida because we provide compassionate, personalized care with advanced treatment options like TMS and medication management, helping individuals find meaningful support, relief, and hope.
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Treatment Options for OCD
TMS Therapy
TMS is used to treat OCD by delivering targeted magnetic pulses to brain circuits involved in obsessive thoughts and compulsive behaviors. The FDA has cleared certain TMS protocols for adults with OCD, including stimulation aimed at areas such as the dmPFC and ACC. During treatment, patients attend a series of outpatient sessions over several weeks, and some protocols include brief symptom provocation beforehand to activate the OCD circuit being treated. TMS is noninvasive and is often considered when symptoms remain significant despite therapy or medication.
Third Party Studies:
- Mantovani et al., 2010: In treatment-resistant OCD, a randomized sham-controlled trial targeting the bilateral supplementary motor area (SMA) found that after 4 weeks, active rTMS produced about a 25% reduction in Y-BOCS versus 12% with sham. In completers, the response rate was 67% with active treatment vs 22% with sham. https://pubmed.ncbi.nlm.nih.gov/19691873/
- Gomes et al., 2012: In a randomized double-blind trial of 22 OCD patients receiving bilateral SMA rTMS, the response rate at 14 weeks was 41% (7/12) with active treatment vs 10% (1/10) with sham. https://pubmed.ncbi.nlm.nih.gov/23224449/
- Ji et al., 2021: In a randomized study of 37 patients, 1-Hz rTMS over the right pre-supplementary motor area (preSMA) led to a clinically significant decrease in Y-BOCS scores compared with sham, and the improvement was reported as maintained 6 weeks after treatment. https://pubmed.ncbi.nlm.nih.gov/34050701/
Medication Management
Medication management is used to treat OCD by carefully selecting, prescribing, and monitoring medications that target obsessive thoughts and compulsive behaviors. SSRIs are commonly the first medication approach for OCD, and effective doses are often higher than those used for depression. Improvement may take 6 to 12 weeks, so regular follow-up is important. A provider may consider including clomipramine, while watching closely for side effects, response, and overall functioning. Med management works best as part of a personalized treatment plan and is often combined with therapy for stronger results.
Third Party Studies:
- DeVeaugh-Geiss et al., 1990 — clomipramine
In exploratory analyses from multicenter clomipramine trials, 519 patients were evaluated. More than half of clomipramine-treated patients were significantly improved, about 30% were minimally improved, and 15% showed no improvement. https://pubmed.ncbi.nlm.nih.gov/2196627/ - Tollefson et al., 1994 — fluoxetine
In a multicenter fixed-dose study, fluoxetine was associated with a statistically significant reduction in OCD severity, including time spent in obsessive and compulsive behaviors. https://pubmed.ncbi.nlm.nih.gov/8031229/ - Zohar et al., 1996 — paroxetine vs clomipramine vs placebo
Paroxetine was significantly more effective than placebo and had comparable efficacy to clomipramine. The study also reported better tolerability for paroxetine on several measures. https://pubmed.ncbi.nlm.nih.gov/8894198/