Obsessive-compulsive disorder (OCD) is a mental disorder characterized by intrusive unpleasant thoughts that arise against the patient’s will (obsessions) and actions (compulsions), the purpose of which is to reduce the level of anxiety. According to a number of studies , obsessive-compulsive disorder (OCD) accounts for 2–3% of the general population. OCD is a disease characterized by a chronic course and an unfavorable social prognosis. Despite the shallow level of damage to mental activity, obsessive-compulsive disorders often show therapeutic resistance. According to some data, in 65% of people with OCD, symptoms become unfavorable, persistent, and significantly reduce the quality of life. In the absence of positive dynamics of psychopharmacotherapy, fourth-line methods are hardware techniques. For a long time, the possibility of using so-called shock methods has been considered in patients with severe forms of OCD treatment: atropinocomatous and electroconvulsive therapy. Atropinocomatosis therapy (ACT) is one of the methods of intensive biological therapy in psychiatry, based on the intramuscular or intravenous administration of high doses of a strong central M-anticholinergic blocker atropine, causing deep depression or loss of consciousness - atropine coma. Some “buts” of ACT that limit its use are: there were two main reasons: 1) the technical complexity and duration of the treatment procedure itself, requiring repeated periods of continuous medical presence for several hours; 2) pronounced changes in the somatic and neurological condition of patients during the period of atropine coma. A good effect from ACT can be expected in severe obsessions , polymorphic, changeable, with metaphysical content, a tendency to systematize and expand the range of obsessions, in cases where they are part of the symptom complex of schizophrenia (when obsessions are in the nature of delirium), while obsessions, structurally close to psychasthenic (anxious), from ACT may worsen. Electroconvulsive therapy (ECT) is the use of electroconvulsive shock as a therapeutic procedure for psychiatric disorders. This technique consists of applying a weak electrical discharge (20 - 30 milliamps) to both temporal areas of the skull before the onset of a grand mal seizure. Currently, electroconvulsive therapy is used as a method to achieve relief of severe psychopathological symptoms after psychopharmacotherapy has been ineffective, or as a first-line method choice in emergency, life-threatening conditions. The role of electroconvulsive therapy is limited to the symptomatic treatment of conditions comorbid with OCD: depression, catatonia. Currently, low-traumatic hardware methods for reducing OCD symptoms are becoming very popular. Transcranial magnetic stimulation is a method of influencing the brain with magnetic pulses of various frequencies. Magnetic impulses in brain tissue form local electric inductive currents, which in turn cause depolarization of neurons. The high ability of the magnetic field to penetrate the skin and bone tissue compared to electric current allows you to more accurately dose the intensity. Another advantage of the technique is the relatively narrow focus of the effect, providing stimulation of local brain structures. To date, there has been an insufficient number of studies on the effectiveness of the method in relation to OCD. The results of a limited number of studies indicate the effectiveness of TMS monotherapy is about 35 - 38%, combined effects - 42 - 43 %. Among all TMS variants, right-sided prefrontal repetitive TMS is the most effective, with a greater reduction in motor compulsions and comorbid depressive symptoms. Vagal stimulation (VS) is a cyclic intermittent technique!