Smart Clinics 6pp A5 Patient Leaflet

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New and effective treatment for depression - a well tolerated alternative to anti-depressants

repetitive Transcranial Magnetic Stimulation (rTMS) Approved by NICE (2015) for the treatment of depression in the UK


What is rTMS Repetitive Transcranial Magnetic Stimulation (rTMS) is is a technological breakthrough in the treatment of depression it utilises pulses of magnetic energy, similar in strength to those produced by a magnetic resonance imaging (MRI) machine. This stimulates the areas of the brain known to control mood. rTMS therapy is a non-invasive, effective alternative for depression, without the use of medication. It does not involve anaesthesia, sedation or any drugs and it does not have the side-effects associated with antidepressants. This treatment is ideal for sufferers from depression who may find antidepressant medication or psychotherapy ineffective or unsuitable. It may also be beneficial for mothers with postnatal depression who wish to breastfeed but do not want to transmit antidepressants to their baby.

How Effective is rTMS ? NICE reached the conclusion in December 2015 that rTMS is effective and safe in the treatment of depression. There are now many scientific studies, which have been published, that have shown that rTMS is an effective treatment for patients with depression, who have not benefited from antidepressant medication. Among the patients who had “treatment resistant depression� (because they had not had any benefit from at least two courses of antidepressant medication), over 30% made a complete recovery from the depression and over 50% had a substantial improvement in their symptoms of depression. rTMS was approved in the USA in 2008 and there are now over 500 rTMS clinics in the USA and there are many hundreds of rTMS clinics operating in mainland Europe treating patients with depression.


Who should consider having rTMS? rTMS is particularly suitable for people who have a depressive illness who have not benefited from at least two courses of different antidepressants. rTMS may also be suitable for people who do not want antidepressant medication and do not want psychotherapy. Mothers who suffer from postnatal depression who are breastfeeding may prefer rTMS to avoid transmitting antidepressants to their baby. rTMS is not suitable for people with any metallic implants or attachments in or around the brain. It is also not suitable for anybody under the age of 18 years old. There is a very small risk of having a brief seizure with rTMS (about 1 in 10,000) and so anyone with an increased risk of epilepsy will need to discuss this risk very carefully with their psychiatrist. About 10% of people who have rTMS experience some minor side effects. These have included: a headache, scalp discomfort and pain over the treatment site. These are relatively mild and transient symptoms, which will respond to simple analgesia. If you would like more information about our rTMS please contact Smart clinics by telephone or email using the details shownon overleaf.


Who Are We?

Dr Leigh A Neal MD FRCPsych. Consultant Psychiatrist

Smart Clinics are an established group of CQC registered medical clinics providing multidisciplinary medical services in central London. rTMS is an outpatient procedure performed in the treatment rooms of Smart Clinics. The treatment service is led by Dr Leigh Neal, who is a Consultant Psychiatrist who has been trained and certified at Maastricht University to provide rTMS. The individual treatment sessions will be provided by a trained rTMS operator.

What to expect from rTMS Therapy You may be referred by your consultant psychiatrist or by your general practitioner. If you have not already seen a consultant psychiatrist we will arrange an assessment with one of our psychiatrists. We have a screening protocol to make sure that our rTMS is suitable for you. Once it has been decided that rTMS treatment is the correct treatment, then the treatment will be provided over 3 to 4 weeks. Each treatment session will last 40 minutes or 4 minutes depending on the type of treatment which is most suitable. You will be comfortably seated in a reclining chair, with your head supported. The magnetic coil is placed near the front of the head on the left side. During the treatment session you will hear a clicking sound and feel a tapping sensation on the scalp. You can watch television, talk or read during the treatment session. As you progress through the therapy we will regularly assess the improvement in your mood , which is normally noticeable during the second or third week of treatment. After each treatment session, you will be able to drive and resume your normal day. rTMS does not involve the use of any drugs and therefore there are no drug side-effects. You can continue to see your own psychiatrist or therapist during the course of the treatment. At the end of the treatment you will be referred back to your usual psychiatrist or therapist.


Testimonials: JANE - struggled with depression for 15 years “I was in and out of therapy and treatment centres. I was on more medications than I can remember. I was so desperate at one point, that I tried intravenous Ketamine. I then heard about TMS and I didn’t expect for it to work. It sounded crazy, but I was willing to try it, since it was non-invasive and wouldn’t have the side effects of ECT. It has completely changed my life. I don’t ever remember feeling this much like myself. The cloud that had been hanging over me has lifted. I have been able to go off of several medications, and I have hope for my future. I have goals and I know that with hard work I can achieve them. I’m still in therapy and on medication, but because of TMS, I am making progress in areas of my life that I wrote off years ago. The best part has been the positive feedback from my parents. They are proud of me and of how far I’ve come. I am grateful they have stuck by me and supported me on my journey. It hasn’t always been easy, but it has been the most rewarding experience of my life.”

GRAHAM - was spending his days too tired or too depressed to do much “I would often sleep for several hours in the afternoon; something that had been far too common since my teens. The TMS treatment has healed the depression I’ve experienced for most of my life by giving me more energy, a more positive outlook on life, and the interest to do things I have always wanted to try; I started to ride my mountain bike just a couple weeks into treatment, which had been sitting unused for 20 years, and tried rock climbing for the first time. While it’s true I’ve ‘lost’ a lot of my life to this, I understand, now, that having depression is not ‘my fault’ and I do not need to blame myself for not being able to ‘just snap out of it’. While TMS is not a cure-all for other emotional issues I still have to deal with, it certainly has lifted the veil and given me the belief and energy to deal with them and to better cope with my life as it is now, as well as restoring a positive outlook for my future. The results of the TMS treatments met all the expectations I was told up front and I couldn’t have asked for a better all-around experience when dealing with such a sensitive issue as my mental health.”

SARAH - first experienced depression in 2010 “My depression has been mild but chronic. Depression has negatively impacted all areas of my life. I decided to receive TMS Therapy because I didn’t like the side effects of medication. I started to notice a change in mood between half way and three quarters of the way through the treatment course. Since receiving TMS Therapy, I am able to enjoy life and friends.”


Testimonials: JOHN - aged 74 “I have suffered with depression for the past 5 years. My symptoms were debilitating. I could not function doing every day tasks such as washing dishes, cooking meals, shopping or making decisions. The supermarket frightened me. I have had tremors on my hand; therefore I could not drive to do this. My wife had driven me to doctor’s appointments. I also had extreme mood changes like I cursed for up to an hour at a time. I had some periods of remission for one month to up to 3 months where my symptoms were gone and I was my normal self. The TMS Transcranial Magnetic Stimulation really worked. I am now back to my volunteering duties, attending board meetings, and enjoying my family. This breakthrough came after 17 sessions on this therapy.”

CATHERINE - diagnosed with bipolar disorder “I was very sick with depression. I tried to kill myself several times and was not successful. My life had no hope or zest. I took medication for my depression. There were times the medication worked, but the medication did not always work. When I was deeply depressed, most of the time I would stay in bed and did not care about my appearance. I would not eat well either. Interacting with other people was extremely difficult for me also. In five years I have been admitted to a psychiatric hospital twenty-two times for depression and suicidal thoughts. The good news is that I have only been admitted to the psychiatric hospital twice in the past two years with very short stays. After being introduced me to Transcranial Magnetic Stimulation (TMS) my life has changed dramatically and I am happy when I arise in the morning. I feel positive about my day and have plans to become employed once again”.

For more information about rTMS please contact: 13 Crescent Place South Kengsington London, SW3 2EA T: 08000 88 60 60 e: info@smarttms.co.uk For more information, Please see our website

www.smarttms.co.uk


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