TMS: A breakthrough treatment for depression & ocd

Treatment-resistant depression is a term used in clinical psychiatry to describe cases of depression that have not responded to at least two trials of antidepressants. Factors that can lead to insufficient treatment include taking too low of a dose, having other concurrent difficult to treat psychiatric and substance use disorders, or stopping the use of medication early — which often happens due to negative side effects.

When considering treatments for treatment-resistant depression, it’s important to look at a wide array of options, as just one may be insufficient for a particularly severe case. A few of the most common kinds of treatment are talk therapy, depression medication and electroconvulsive therapy (ECT).

  • Talk therapies, like cognitive behavioral therapy (CBT) or interpersonal psychotherapy (IPT), are crucial treatments for depression. Talk therapy can help a patient identify stressors and develop positive coping mechanisms or adjustment strategies. However, in order for talk therapy to be completely effective, an accompanying medication may be necessary.
  • Depression medication can be quite effective if the side effects can be tolerated. In cases of treatment-resistant depression, options can be limited, but a different class of antidepressant may prove effective as expressed in the STAR*D trial.
  • ECT is one of the more powerful treatments for depression and can be effective for patients who are at imminent risk for suicide or depressive cases marked by psychotic features, but the side effects of ECT can be severe. At this time, most insurance plans cover TMS for major depressive disorder. However, TMS for obsessive-compulsive disorder is not yet covered by insurance.
Patient watching video TMS

A Modern Treatment Method

A more modern option available for treatment-resistant depression is transcranial magnetic stimulation. TMS is proven to be successful without the concurrent use of antidepressants. It’s been found to be very helpful for patients with resistant depression or who are adverse to taking depression medication because of side effects.

Relief for Treatment-Resistant OCD

Obsessive Compulsive Disorder is commonly treated with medication, therapy, or a combination of both. Depending on the definition used, 30–60% of patients on medication are treatment-resistant, meaning they do not respond to medication or therapy. For these patients, transcranial magnetic stimulation becomes one of the few viable options available.

TMS is a non-invasive, FDA-cleared treatment for OCD patients whose symptoms have not improved with at least two antidepressant prescription treatments or have not achieved the desired results. TMS uses a highly focused, pulsed magnetic field to stimulate the regions of the brain involved in mood regulation.

Please note that among insurance companies that provide coverage for TMS treatment, only depression is currently recognized as a qualifying condition.

    Treating Both Components of OCD

    Obsessive compulsive disorder is a combination of uncontrollable thoughts and behaviors. The treatment course at Active Path Mental Health addresses both of these components by combining elements of exposure response prevention (ERP) with TMS therapy.

    Our providers work with each patient to create a “provocation” list which helps activate the specific circuits of the brain affected by OCD. The TMS treatment works to interrupt these circuits which, over the course of treatment, can lead to a reduction in symptoms. The course of treatment is six weeks long with a total of 29 treatments. Each session takes 30-40 minutes.

    Peer-reviewed studies have shown significant improvement in patients’ Y-BOCS scores, the standard measurement for OCD symptoms. In one study, over 45% of patients in the active treatment group had a significant improvement in their Y-BOCS scores compared with almost 18% in the sham treatment group.

    TMS therapy is now FDA-cleared for anxious depression

    In 2021 a new indication, anxious depression, was cleared by the FDA for treatment using transcranial magnetic stimulation.

    Anxious depression refers to the anxiety symptoms present in patients suffering from Major Depressive Disorder (MDD). It affects approximately 10-16 million adults in the United States each year. This definition is distinct from patients who experience depression that is triggered by a primary diagnosis of an anxiety disorder, such as generalized anxiety disorder (GAD) or panic disorder. Anxious depression is linked to greater severity of depression symptoms, higher risk of suicide, reduced response rates to treatment, and higher risk of cardiovascular disease and diabetes.

    TMS Treatment for Anxious Depression

    Transcranial Magnetic Stimulation (TMS) is an FDA-cleared treatment for anxious depression and is covered by most insurance plans. TMS is non-invasive, does not require anesthesia, has no systemic side effects, and can be easily incorporated into the patient’s daily schedule. Patients can drive themselves to and from treatment. The treatment protocol for anxious depression mirrors the one for depression so there is an added benefit for patients who may have only been treated for depression in the past.
    Serene woman sitting in sunny field

    Can TMS Be Used To Treat Other Conditions?

    Transcranial magnetic stimulation has been used to treat various mental health conditions, including anxiety, depression, obsessive compulsive disorder. The Food and Drug Administration has cleared TMS to treat depression, anxious depression and OCD. BrainsWay’s Deep TMS has also been approved as an aid in short-term smoking cessation.