TMS for OCD

The cleared option

Deep TMS with an H7 coil received FDA clearance for OCD in 2018, and other coil systems have since been cleared. Trials show about 40 percent of patients with treatment-resistant OCD respond (a 30 percent or greater drop in Y-BOCS), with benefit maintained at follow-up in many. See the coverage hub, the TMS hub, and the coverage checker.

Who is a candidate

Adults with moderate to severe OCD that has not responded to exposure and response prevention and at least two SSRI trials at adequate dose and duration. The same seizure and metal exclusions apply as for depression TMS.

What treatment looks like

Daily sessions for about six weeks. OCD protocols often include a brief symptom provocation before each session to engage the relevant circuitry, which can feel uncomfortable for a few minutes.

Coverage and cost

Coverage lags the FDA clearance: many commercial policies still list TMS for OCD as investigational, while a growing number cover it with prior authorization. Ask the clinic to check your specific policy. Cash courses run $6,000 to $14,000. See TMS coverage and TMS providers by state.