OCD Treatment in Marylebone, London
OCD treatment in Marylebone, London for people whose intrusive thoughts and compulsions have not settled with therapy and medication alone. We will tell you at the free consultation whether magnetic stimulation is a reasonable option for you, and the evidence in OCD is thinner than in depression, so that conversation matters.
Overview
Understanding OCD
OCD is a loop. An intrusive thought arrives, it brings anxiety with it, and a ritual brings brief relief. The relief teaches the brain to run the loop again. Most people with OCD know the loop is not rational, which is part of what makes it exhausting.
Underneath it sits a circuit that neurologists know well: the loop running from the front of the brain through the striatum and thalamus and back again. It is the circuit that decides when an action is finished. In OCD that signal does not arrive, so the check gets repeated.
Magnetic stimulation aims at that circuit. We do not aim at a fixed scalp coordinate. Your motor threshold is measured first, so the dose is calibrated to you, and candidate sites are tested so the target is chosen by your own response.
Here is the honest position on evidence. The international consensus guidelines published by Lefaucheur and colleagues in Clinical Neurophysiology in 2020 rate the OCD evidence below the depression evidence. NICE guideline CG31 recommends cognitive behavioural therapy with exposure and response prevention, and SSRI medication, as first-line care for OCD. Both stay first-line while you are with us. Ask us at the consultation what the evidence here actually supports. You should expect a straight answer.
Why it happens
What causes OCD?
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Altered activity in the loop running from the front of the brain through the striatum and thalamus, the circuit that signals when an action is complete
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Overactivity in the orbitofrontal cortex and the anterior cingulate cortex
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Differences in serotonin and glutamate signalling, which is part of why SSRI medication helps some people
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A genetic contribution, with OCD appearing more often in close relatives
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Learned reinforcement: a compulsion relieves the anxiety briefly, so the loop strengthens each time it runs
Treatment approach
How we treat OCD in Marylebone
NayaScore assessment
On enquiryBefore anything is treated we take a baseline. NayaScore covers grip strength, continuous heart rate variability from a wearable ring, and cognitive testing across twelve domains, including response inhibition, which is the domain most relevant to a compulsion. It is a measurement tool rather than a diagnostic test, and results are interpreted alongside clinical judgement.
See treatment detail →Precision rTMS
From £350 a sessionStimulation is aimed at the prefrontal circuit involved in OCD, at a dose set from your own motor threshold. The evidence base in OCD is smaller and less consistent than in depression, and your clinician will say so plainly at consultation rather than after you have paid for a course.
See treatment detail →Heart-brain coupling
On enquiryCandidate sites over the dorsolateral prefrontal cortex are tested and the one producing the clearest slowing of your heart rate is chosen, which indicates the network linking the front of the brain to the vagus nerve has engaged. It replaces a fixed scalp coordinate with a measured one.
See treatment detail →Integrated therapy
On enquiryExposure and response prevention is the first-line psychological treatment for OCD and stimulation does not replace it. Where you are already doing that work with someone else, we keep out of the way. Where you are not, we can talk about how the two fit together.
See treatment detail →Restore programme
From £350 a sessionRestore is the pathway for people below their own baseline with a diagnosed condition, which is where most people with OCD arrive. It sets the course length, the review points and the measures at the start, so the question of whether it is working gets answered with data.
See treatment detail →Progress tracking
On enquiryThe same measures are repeated during the course, so a change in your response inhibition score or your heart rate variability is visible while there is still time to act on it. If the numbers are not moving, we would rather tell you at week three than at week six.
See treatment detail →FAQ
OCD questions
Can rTMS help my OCD?
Sometimes, and the honest position is that the evidence is thinner than in depression. The international consensus guidelines published by Lefaucheur and colleagues in Clinical Neurophysiology in 2020 rate OCD below depression. Your clinician will tell you at consultation which category you fall into, before you pay for anything.
Should I stop my OCD medication or my therapy?
No. Do not change anything without speaking to whoever prescribes it. Magnetic stimulation is used alongside your existing treatment here, not instead of it. NICE recommends cognitive behavioural therapy with exposure and response prevention, and SSRI medication, as first-line care for OCD. Both remain first-line while you are with us.
How many sessions would I need?
Your clinician will give you a number after your assessment, not before it. Courses here have run from five sessions to thirty depending on the condition and the response. For OCD we would set a review point early, reassess with the same measures, and stop if your numbers are not moving.
Will the NayaScore assessment tell me whether I have OCD?
No. NayaScore is a measurement tool, not a diagnostic test, and its results are interpreted alongside clinical judgement. It combines grip strength, continuous heart rate variability from a wearable ring, and cognitive testing across twelve domains. Diagnosis of OCD is a clinical assessment, made by a psychiatrist or your GP.
What does a session actually feel like?
Most people describe a light tapping against the scalp and nothing worse. You sit upright and awake in a low-lit room while the coil delivers pulses in short trains. Mild scalp tenderness or a dull headache afterwards is the common side effect, and it usually settles within two hours.
Related What we treat
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Naya • 1 Orchard Street, London W1H 6HJ
BookAppointments typically available within 1–2 weeks