Transcranial Magnetic Stimulation is becoming a popular treatment for depression that has minor and transient side-effects. 3/4 people respond to the treatment with significant improvements in their depressive symptoms as well as improving quality of life.
It is important to fully understand what TMS treatment is and what it involves. As a result, we have put this ‘TMS depression guide’ together for your review.
- How does Transcranial Magnetic Stimulation (TMS) work?
- History & development
- Depression and its symptoms
- Treating depression with TMS
- TMS treatment for Post-partum depression
- Treatment side-effects
- TMS treatment & talking therapies
- NHS availability
- Suitability for treatment
- Cost of TMS treatment
- TMS treatment reviews
Transcranial Magnetic Stimulation (TMS) is a non-invasive, safe and painless treatment. TMS сrеаtеѕ a mаgnеtiс fiеld to induce a ѕmаll еlесtriс сurrеnt in a ѕресifiс part оf thе brain (left pre-frontal cortex); the current comes frоm thе mаgnеtiс field created bу аn electromagnetic соil thаt dеlivеrѕ рulѕеѕ through thе fоrеhеаd.
Although they are small, induced electric currents in the brain that can cause the neurones to become more active. It is this stimulation which is believed to trigger changes in the brain circuits responsible for depression. In other words, the magnetic pulses delivered from the TMS coil reinvigorate parts of the brain that might not be working properly in depressed patients.
Current research suggests that when small electrical currents are induced in the prefrontal cortex of the brain, there is an increase in blood flow and glucose metabolism, leading to increased neurone activity which appears to elevate mood. The TMS coil stimulation in the part of the brain that regulates mood is believed to activate brain cells, which triggers a cascade of neurochemical events, including the release of neurotransmitters (such as serotonin and dopamine) helping normalise neurotransmitter function.
The development of the first modern TMS device was initiated in 1985 by Professor Anthony Barker and Colleagues in Sheffield. However, the underlying principle of electromagnetism was first discovered by Michael Faraday in 1831. As a result, TMS has then introduced into psychiatry and this lead into vast amounts of research for the treatment of depression.
TMS treatment was approved by the FDA in 2008 and with further progress, in 2015 the National Institute for Health & Care Excellence (NICE) recommended the treatment for depression in the UK.
An estimated 1 in 6 people experienced a ‘common mental disorder’ like depression or anxiety in the past week. Around 1 million people received psychological therapy for a common mental disorder through the IAPT programme in 2016/17 (Mental health England Statistics, House of Commons library).
Everyone will experience depression differently with varying severity. Nonetheless, there are depressive symptoms that are common such as constant feelings of low, anxiety, hopelessness, poor motivation and confidence. Extreme symptoms of depression can make you feel suicidal, fatigued and cause disturbed sleep and poor appetite.
Studies have shown that the front-left side of the brain is an area that can be under-active in individuals with depression, hence the rationale for the site of the stimulation.
The significant benefits of TMS treatment for depression are seen in the positive psychological aspects such as improved positive mood, calmed anxiety symptoms,
TMS significant improvements are seen in positive psychological bеnеfitѕ fоr at lеаѕt a уеаr after treatment (with research following up individuals who have completed a course of TMS treatment). Thеrе is some еvidеnсе that TMS mау improve the brain’s ability to рrосеѕѕ brain сhеmiсаlѕ on its own, essentially re-programming the brain’s neural-pathways tо prevent depression.
Benefits of TMS
- Improved mood
- Stable mental state
- Improved cognitive & executive functions
- Reduced anxiety
- Increased motivation
- Improved sleep and appetite
Postnatal depression (PND) аlѕо known аѕ postpartum depression (PPD) iѕ a tуре оf depression ѕоmе wоmеn experience аftеr having a baby. Between 10 and 30 per cent of all nеw mothers reportedly ѕuffеr from postnatal depression.
Post-natal depression symptoms could last months or even longer and can get worse. These symptoms can have a significant impact on you and your baby. Therefore, it is important to seek help as soon as you feel depressive symptoms.
TMS treatment has become a viable option for treating postnatal depression due to its safety and efficacy. Since new mothers prefer not to be on medication during and post pregnancy. TMS treatment offers a medication-free option for treating depressive symptoms both during and after pregnancy.
Transcranial Magnetic Stimulation has minor and transient side effects. Mild scalp irritation and mild headache affect nearly one-half of all patients and usually goes away after the first week of treatment. Also, some individuals experience transient drowsiness/lightheadedness. Nonetheless, these side-effects are minor and patients can return to daily activities straight after the treatment.
Serious side effects of TMS treatment are rare. They may include:
- Seizures (1 reported in 30,000 in clinical studies)
- Mania, particularly in people with bipolar disorder
- Hearing loss if there is inadequate ear protection during treatment
You can compare the side effects of TMS treatment to medication and ECT below.
Even though TMS treatment improves depressive symptoms as mentioned earlier. However, some patients may have more complicated issues that require talking therapies. Therefore, a combination of TMS treatment and talking therapies will help the patient both feel better and tackle underlying issues.
Talking therapies such as cognitive behavioural therapy (CBT) has been utilised for many years in helping individuals with to overcome their depressive symptoms.
The concept of CBT is that your thoughts, feelings and behaviour are interconnected and this can become a vicious cycle for someone with depression. CBT aims to deal with problems more positively and to break them down into smaller parts so that it can be dealt with more effectively.
Is TMS available on the NHS; At the moment Transcranial Magnetic Stimulation (TMS) for the treatment of severe depression is not available on the National Health System (NHS) in the Yorkshire region. The rTMS Centre (Sheffield) has worked with individuals towards getting funding for their TMS treatment in the Yorkshire region. However, funding is subject to strict criteria and in the majority of cases funding is not yet accepted.
Patient demand for the TMS treatment will encourage the NHS to look into the treatment for individuals that have exhausted other treatment options for their depressive symptoms.
The NHS site has published a brief guideline on TMS treatment.
- Bi-polar (depression) patients
- Patients with a history of epilepsy
- Patients with Implanted Cranial Electrodes
- Patients with cochlear implants
- Patients with pacemakers
After your initial consultation, the number of sessions prescribed for the treatment of severe depression is 20 to 30 sessions. Nonetheless, the average number of sessions for the treatment of clinical depression is 20 sessions.
The cost of one course (20 sessions) of treatment for depression is £3000, at £150 per session. The initial consultation and follow-up fee are £300.
Here are some of our reviews:
I have had a fantastic experience with this company. Clinic Manager Nima has been incredibly attentive, professional and helpful during my treatment and Dr Matta has been instrumental in helping me further understand my health and how I can manage it going forward.
rTMS has been very effective for me and this is a great place to try it.
I have been on medication for anxiety since I was 15 and antidepressants since I was 19. Though they helped I never felt like things were managed. I began to notice a change by the 3rd week of treatment. I no longer feel on edge or worried all the time and have already reduced my anxiety medication drastically and am working on decreasing my antidepressants. Close family and friends have even commented that I seem more “chipper”.
Dr. Matta and Nima were really friendly and helpful throughout the entire process.