Obsessive-compulsive disorder responds well to SSRIs and exposure-and-response-prevention therapy for many people, but about a third have residual symptoms. For these treatment-resistant cases, deep brain stimulation, transcranial magnetic stimulation, and emerging medications are expanding options.
What's actually going on in research
Trials are testing newer medications including glutamate-targeted drugs, intensive and digital exposure therapy programs, deep brain stimulation, transcranial magnetic stimulation, and psilocybin-assisted therapy. Researchers are also studying OCD in children, OCD with hoarding, and treatments for related conditions like body dysmorphic disorder.
Brain stimulation
TMS and deep brain stimulation can help people whose OCD has not responded to medications and therapy. Newer TMS schedules deliver treatment in days rather than weeks.
New medications
Drugs targeting glutamate and other newer pathways are being tested for OCD that resists SSRIs. Some trials combine these with intensive exposure therapy.
Digital exposure therapy
App-based and video-supported exposure-and-response-prevention is making evidence-based therapy accessible to people who cannot find a trained therapist nearby.
What to know before you search
Eligibility often depends on severity, prior medications and therapy tried, and presence of related conditions like depression, tics, or body dysmorphic disorder.
What types of trials are currently open
- Therapy trials — Testing exposure-and-response-prevention therapy in person, intensively, or through digital programs.
- New medication trials — Testing SSRIs, glutamate-targeted drugs, and other medications for OCD.
- Device trials — Studies of TMS and deep brain stimulation for OCD that has not improved with medication and therapy.
- Psychedelic-assisted therapy trials — Testing supervised psilocybin combined with therapy for OCD.
- Pediatric trials — Testing treatments specifically in children and adolescents with OCD.
Recently added OCD trials
Electrophysiological Biomarkers and Treatment Response to Accelerated Transcranial Magnetic Stimulation in Patients With Obsessive-Compulsive Disorder
Purpose: This study aims to evaluate the effectiveness of an accelerated intermittent Theta Burst Stimulation (iTBS) protocol-a non-invasive brain stimulation technique-targeted at the dorsomedial prefrontal cortex (dmPFC) and anterior cingulate cortex (ACC) in patients with treatment-resistant Obsessive-Compulsive Disorder (OCD). Additionally, the study seeks to identify electrophysiological biomarkers (such as EEG microstates and heart rate variability) that may predict which patients are most likely to benefit from the treatment. Methodology: The study will include 30 patients aged 18-65 diagnosed with OCD according to DSM-5 criteria who have not responded sufficiently to standard treatments. Participants will undergo an intensive 7-day treatment program consisting of 4 iTBS sessions per day (totaling 28 sessions). Clinical symptoms will be assessed before and after the treatment using standardized scales, including the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A). Resting-state EEG measurements and heart rate data will be recorded during and after the sessions to analyze physiological changes. Goal: The findings are expected to contribute to the development of personalized neuromodulation protocols and help identify predictors of treatment response for OCD patients.
OCD LIFU Target Engagement
The investigators will conduct a pilot study to evaluate the safety and feasibility of low-intensity focused ultrasound on obsessive-compulsive disorder (OCD) symptoms when delivered to subcortical brain targets. The investigators will use the ATTN201 device to deliver single sessions of unfocused and focused ultrasound to up to three brain targets over 4 study visits and assess the intervention through self-rated scales of OCD symptoms.
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