The evidence accumulated so far with regard to Electroconvulsive Therapy (ECT) is not compelling, and altogether, it seems that the pure anti-obsessional effect of ECT is questionable. ECT should probably be reserved for the symptomatic (antidepressive) treatment of severely depressed and suicidal OCD patients.

Neurosurgery has been reported to be effective in some OCD patients, with procedures that disconnect the outflow pathways originating from the orbitofrontal cortex. Cingulotomy can help some intractable patients, but while immediate results may be striking, the long-term prognosis is more reserved.

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