Treating depression and OCD with rTMS
Globally, more than 300 million people of all ages suffer from depression.
Depression is the leading cause of disability worldwide and is a major contributor to the overall global burden of disease. (WHO 2018).
Depression is a debilitating condition that can have profound effects on the quality of a person’s life.
Approximately a third of those suffering from depression do not respond to pharmaceutical and/or psychological treatment.
Obsessive Compulsive Disorders, known as OCD, is a condition characterised by unwanted thoughts and repetitive impulses. Only about 60% of patients with OCD improve with medication and at least 75% will relapse in the months after stopping the drug.
What is rTMS?
rTMS provides an effective non-pharmaceutical treatment to mental health problems with limited side effects. Repetitive Transcranial Magnetic Stimulation, known as rTMS, is a form of non-invasive brain stimulation
How rTMS sessions look like?
rTMS is an outpatient treatment. In each session the patient is comfortably seated on a chair, and a cushioned helmet is gently placed over the head. The helmet generates brief magnetic fields, similar to those used in magnetic resonance imaging (MRI) systems. These magnetic fields briefly stimulate the targeted brain area and improve depressive symptoms.
The procedure requires daily sessions of 20 minutes over 4-5 weeks . After each sessions, patients can return home independently, and follow through their normal daily routine.
Who is delivering rTMS session?
The delivery of rTMS at Nightingale Hospital is administered by an expert rTMS practitioner, who has acquired a strong clinical understanding thanks to her experience in the UK and in Europe over the years. Every patient is assessed by one of our consultant psychiatrists to determine if rTMS is an appropriate treatment for them.
Is rTMS a safe treatment?
rTMS has been tested in over 60 clinical studies worldwide. In the UK, The National Institute for Health & Care Excellence (NICE) provides independent national evidenced based guidance and advice to improve health. rTMS has been approved by NICE since 2015. You can read the updated guidance here.
It has been fully licensed by the Food and Drug Administration (FDA) in the USA since 2008, and is routinely used to treat depression in many first class international hospitals (e.g. Johns Hopkins Hospital, USA) and in centres across Europe.
What are the benefits of rTMS?
- Research and clinical trials worldwide have reported it to be an effective treatment for depression and OCD
- rTMS is a non-invasive treatment, which requires no sedation
- It is an outpatient treatment, and well tolerated by majority of people
- People experience minimal side effects
- Daily activities can be resumed immediately after each session (e.g driving)
Is rTMS effective treatment?
Studies shown that rTMS is an effective treatment for depression. The H-coils may be expected to produce antidepressant effects of greater magnitude than those of standard TMS due to the stimulation of deeper and more widespread prefrontal reward-mediating neural pathways. Ref: Roth Y, Levkovitz Y, Pell GS, Ankry M, Zangen A. Brain Stimulation, 7:194-205 (2014)
TMS is a non-invasive approach used for stimulating the human brain according to Zangen et al. (2002). Repetitive stimulation over the prefrontal cortex has proven effective in the treatment of major depression.
Berlim et al. (2014) showed a positive therapeutic effect of deep TMS in treatment-resistant depression (TRD) and showed it is safe and relatively well tolerated. Response and remission rates showed significance; depression, anxiety and suicidality rates were significantly improved by week 5.
Harel et al. (2014) examined the safety and feasibility of dTMS continuation treatment for MDD over a long term of 18 weeks, following 4 weeks of acute treatment, the study suggests that dTMS continuation treatment could help maintain an antidepressant effect for 18 weeks, following 4 weeks’ acute treatment.
What are the side effects of rTMS?
rTMS treatment has been proven safe and effective and has no known systemic side effects.
The most common side effects are:
• Scalp discomfort at the site of stimulation
• Tingling, spasms or twitching of facial muscles
• Discomfort from noise during treatment
• Other rare side effects include seizures (2 per 1,000 cases)
In 2014 Nightingale Hospital in partnership with MagnaCentre was the first, and today remains the only private hospital in the UK offering rTMS using a BrainsWay H-coil.
rTMS is typically delivered using a figure-8 shaped coil. The highly-focused stimulation field of a figure H-coils have been designed to deliver a deeper and wider magnetic field, than standard figure-8-coils.
Pulses delivered by H-coil are able to reach depths of 4cms and multiple areas into the brain, compared to an 8-coil which only reaches depths of 1.5cm.
This means that the H-coils supply a wider field of penetration, designed to stimulate the brain regions more consistently leading to greater effectiveness which has led to the term ‘Deep TMS’ or DTMS.
For more information, please contact firstname.lastname@example.org
Telephone: +44 (0)20 7535 7803
Below are just some of comments that patients have made regarding their treatment:
“I have a reason to get up in the morning now. The treatment has made a positive difference to my mood”
“I feel much more motivated to do daily tasks that felt impossible before starting treatment. I have even been able to go back to work”
“I would recommend the treatment to anyone suffering from depression, it has really made a positive difference to my mood”
Most private medical insures are at present reviewing applications to fund on a case-by-case basis.
Typical duration of treatment: 20 sessions
Price range: £185* per session