No. In the pivotal trial, remission (a YBOCS score below 10) was rare at six weeks: 2 of 42 patients with active treatment and 2 of 45 with sham. A response meant a symptom drop of at least 30%, not the end of OCD. NIMH states that there is no cure for OCD, but treatment helps people manage symptoms.

How long do the results of TMS for OCD last?

The pivotal trial followed patients for one month after treatment. The response rate was 45.2% with active TMS and 17.8% with sham at that point. A 2026 meta-analysis of 31 trials found no significant change in scores between the end of treatment and follow-up. The FDA record states that long-term effects of repetitive TMS are unknown.

Do I stop my OCD medication during TMS?

Not usually. The FDA authorized TMS as an adjunct, and patients in the pivotal trial stayed on their SSRI, their behavioral therapy, or both. The FDA summary says current treatment should stay at the same dose during the course. Your prescriber decides this, and you should not change a dose on your own.

Does TMS for OCD hurt?

It can be uncomfortable. Headache was the most frequent complaint in the pivotal trial, reported by 37.5% of patients with active treatment and 35.3% with sham. Scalp, jaw, or facial discomfort and muscle twitching also occurred. The FDA summary says the discomfort faded for most patients as they got used to treatment.

Is TMS approved for children or teens with OCD?

No. The FDA indication is for adult patients. The pivotal trial enrolled people aged 22 to 68, and the FDA record states that safety and effectiveness are not established for people younger than 22.

Does TMS Work for OCD?

The short answer: Yes, for some people. The effect is moderate. In the trial behind the first FDA authorization, 38.1% of adults who had active deep TMS responded after six weeks, against 11.1% who had sham treatment. Response meant a drop of at least 30% on the Yale-Brown Obsessive Compulsive Scale (YBOCS). TMS is an add-on for adults whose OCD has not improved enough with exposure therapy or medication. It does not replace them.

What is TMS for OCD?

TMS stands for transcranial magnetic stimulation. A coil sits against the scalp and sends brief magnetic pulses into the outer layer of the brain. The FDA classification record describes these devices as prescription, non-implantable systems that use pulsed magnetic fields to induce neural activity in the cerebral cortex. It involves no surgery.

The National Institute of Mental Health (NIMH) notes that repetitive TMS is most commonly used to treat depression. For OCD, the coil targets different areas. The pivotal OCD trial aimed at the medial prefrontal cortex and the anterior cingulate cortex. "Deep" TMS was designed to reach wider and deeper brain regions. NIMH states that FDA authorization for OCD started with deep TMS and was extended to standard TMS devices in 2022.

Is TMS FDA cleared for OCD?

Yes. Three FDA records show the sequence:

BrainsWay Deep TMS System. The FDA granted a De Novo request (DEN170078) for this device. NIMH dates the first OCD authorization to 2018.
MagVenture TMS Therapy system. The FDA cleared it through a 510(k) (K193006) in a letter dated August 9, 2020. The summary states that the filing did not include new pivotal data. It relied on the BrainsWay trial.
NeuroStar Advanced Therapy. The FDA cleared it through a 510(k) (K212289) in a letter dated May 6, 2022.

The indication wording is the same in all three records: the system is "intended to be used as an adjunct for the treatment of adult patients" with obsessive-compulsive disorder. Adjunct means added to existing care, not used alone.

How well does TMS work for OCD?

The best single source is the pivotal trial published in the American Journal of Psychiatry in 2019. It enrolled 99 patients at 11 centers. Patients were randomly assigned to 20 Hz deep TMS or sham treatment every weekday for six weeks.

Symptom scores: YBOCS scores fell by 6.0 points with active treatment and 3.3 points with sham.
Response at six weeks: 38.1% with active treatment and 11.1% with sham. Response was defined as a YBOCS reduction of 30% or more.
Response one month later: 45.2% with active treatment and 17.8% with sham.

The FDA review adds detail that the journal abstract leaves out. Remission, defined as a YBOCS score below 10, was rare in both groups at six weeks: 2 of 42 patients with active treatment and 2 of 45 with sham. The FDA also noted that the main result did not reach statistical significance in every analysis population. It still judged that the trends pointed to a probable benefit.

Pooled studies agree on a moderate effect. A 2023 meta-analysis of 25 randomized trials with 860 participants found a moderate effect on symptom severity (g = 0.65). Patients were about three times as likely to respond with real TMS as with sham (relative risk 3.15).

A newer review is more cautious. A meta-analysis of 31 trials published in 2026 found that TMS lowered YBOCS scores by 3.30 points more than sham. The authors note that this is below the 4.9-point minimal clinically important difference. The number needed to treat for one response was 6.

Who is TMS for?

The International OCD Foundation (IOCDF) says TMS is for people who have tried ERP, medication, or both and are still struggling.

Per the FDA summary, participants were outpatients aged 22 to 68 with at least moderate OCD (a YBOCS score above 20). They stayed on a stable SSRI dose for at least two months before the study, stayed in behavioral therapy, or both.

The same FDA record lists people for whom the device is contraindicated or untested:

Contraindicated: metal or magnetic-sensitive objects in or near the head, such as cochlear implants, aneurysm clips, stents, or implanted stimulators.
Not established as safe and effective: people younger than 22 or older than 68, people with a history of seizures or other neurological disorders, people with cardiac pacemakers, and people who are pregnant or nursing.
Also not established: people on clomipramine or on high doses of medications known to lower the seizure threshold.

That last point matters because OCD may need higher SSRI doses than depression does. See why SSRI doses for OCD are higher.

What does a course of TMS involve?

In the pivotal trial, patients had treatment five days a week for six weeks. The IOCDF describes current practice as five days a week over four to six weeks.

A typical session in the trial ran like this:

Symptom provocation. For up to five minutes, staff brought up the patient's own obsessions to produce moderate distress. The aim was to activate the relevant brain circuits.
Ear protection. The FDA record requires earplugs rated for at least 30 dB of noise reduction.
Stimulation. The device delivered 2,000 pulses in 2-second bursts with 20-second pauses. Stimulation took about 20 minutes of a session that lasted about 30 minutes.

The IOCDF says that insurers may require prior authorization, may require other treatments first, or may not cover TMS at all.

What are the side effects and seizure risk?

Headache was the most frequent side effect in the pivotal trial. The FDA summary reports it in 37.5% of patients who had active treatment and 35.3% who had sham. Other complaints, such as coil-site, jaw, or neck pain and muscle twitching, were mild or moderate and mostly resolved after treatment.

The trial had one serious adverse event: suicidal thoughts that led to a hospital admission. The investigator and sponsor judged it unrelated to the device. The FDA concluded that the risks of the device for OCD "are considered low."

The FDA lists seizure among the identified risks for this device type. It requires the labeling to give instructions to prevent seizures, to monitor for them, and to manage one if it occurs. It advises caution in anyone with a seizure history. The IOCDF calls seizures a rare side effect. Neither source gives a seizure rate for OCD treatment, so this article does not give one.

The FDA record also states that the long-term effects of exposure to repetitive TMS are unknown.

How does TMS compare with ERP and SSRIs?

ERP and SSRIs come first. NIMH lists TMS under "other treatments" for people with severe OCD who did not respond.

ERP: NIMH says exposure and response prevention reduces compulsive behaviors, even in people who do not respond well to medication. See our guide to ERP therapy for OCD.
SSRIs: NIMH says these can take 8 to 12 weeks before symptoms begin to improve. Our OCD medication options page covers the choices.
TMS: an adjunct, used with medication, therapy, or both.

The IOCDF says about 70% of people benefit from ERP, medication, or both. The deep TMS trial reported a 38% to 45% response, but it enrolled people who had not responded well to earlier treatment, so the two figures are not a direct comparison. The comparison is not like for like, though. People in the TMS trial had already had an inadequate result from standard treatment.

The FDA review states that approved OCD medications produce benefits similar to the device, a YBOCS reduction of about 6 points. It also states that 40% to 60% of people with OCD do not have a satisfactory response to medication.

The 2023 meta-analysis also found that OCD improved more with TMS when depression improved too. Our sibling site depression.md covers that condition.

The bottom line

TMS works for OCD in a specific sense. In sham-controlled trials, it roughly triples the chance of a meaningful drop in symptoms, and about 4 in 10 treated patients respond. Full remission is uncommon. The FDA has authorized it only as an add-on for adults. It suits people who still have significant symptoms after ERP and an SSRI. If that describes you, ask an OCD specialist if TMS is a reasonable next step.

Last updated: October 2026. This article is for informational purposes only and does not constitute medical advice. Talk with a psychiatrist or OCD specialist before you start, stop, or change any treatment, including TMS.