Obsessive-Compulsive Disorder (OCD) is a chronic and often debilitating mental health condition that affects millions worldwide. While many find relief through standard treatments such as therapy and medication, a significant number of individuals continue to struggle with persistent, treatment-resistant symptoms.
Fortunately, transcranial magnetic stimulation (TMS)—a non-invasive neuromodulation therapy—is already FDA-approved and clinically effective for OCD. Now, new research is enhancing this proven treatment with innovative combinations that may lead to even faster and more robust results.
How TMS and Neuromodulation Target OCD
TMS works by using magnetic pulses to stimulate specific brain circuits involved in mental health conditions. In OCD, researchers have mapped out the neural networks responsible for intrusive thoughts and compulsive behaviors. By precisely targeting these circuits, TMS helps rebalance brain activity and reduce symptoms.
A powerful variation of TMS known as intermittent theta burst stimulation (iTBS) delivers brief, high-frequency bursts of magnetic stimulation. This approach is not only effective—it’s also more time-efficient, with sessions taking just a few minutes compared to standard protocols.
Boosting Neuroplasticity: iTBS Plus D-Cycloserine
Researchers have been exploring how to make TMS even more effective by pairing it with medications that enhance neuroplasticity—the brain’s ability to rewire itself. One such medication, D-Cycloserine, has shown promise in accelerating the benefits of brain stimulation.
A recent randomized clinical trial in Canada evaluated the effects of combining iTBS with D-Cycloserine in patients with treatment-resistant OCD. The study divided participants into four groups:
Sham stimulation + placebo
Sham stimulation + D-Cycloserine
iTBS + placebo
iTBS + D-Cycloserine
After just four weeks, the group receiving both iTBS and D-Cycloserine experienced a significant reduction in OCD symptoms, with a notably large effect size compared to the other groups. These results suggest that D-Cycloserine may help the brain respond more rapidly and deeply to the benefits of TMS.
The Future of TMS for OCD: Refining a Proven Therapy
These findings don’t point to a brand-new treatment—they demonstrate how researchers are making an already-approved and effective therapy even better. TMS is not experimental; it’s FDA-approved for OCD and backed by a growing body of clinical evidence. These innovations are about optimization, helping more people see results faster and potentially with fewer sessions.
Access to adjunctive treatments like D-Cycloserine remains a hurdle, and more research is needed to refine protocols and determine long-term benefits. However, the direction is clear: neuromodulation is transforming the landscape of psychiatric care, and for those living with OCD, this evolution offers renewed hope and improved outcomes.
References
McGirr, A., Cole, J., Patten, S. B., & Adams, B. (2025). Intermittent Theta Burst Stimulation With Adjunctive D-Cycloserine for Obsessive-Compulsive Disorder: A Randomized Clinical Trial. American Journal of Psychiatry, 182(3), 307–311. https://doi.org/10.1176/appi.ajp.20240181
The Human Connectome Project. (2025). National Institutes of Health. https://www.humanconnectome.org
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