TMS treatment for depression
Transcranial Magnetic Stimulation (TMS) is an innovative approach to treating depression.
The treatment was approved by the National Institute for Health and Care Excellence (NICE) in 2015. It’s a non-invasive therapy that uses magnetic pulses to stimulate the area of the brain that controls your emotional reactions and regulates mood.
Depression takes away the good things in life – your relationships, your energy, even your dreams for the future; TMS can give you these things back.
What causes depression? Is it treatable?
Depression affects more than 1.5 million adults in the UK. While the exact cause is unknown, it’s characterised by an imbalance of the brain’s neurotransmitters (chemical messengers that send signals between brain cells) and decreased activity in the frontal lobes of the brain.
Dr Leigh Neal explains
Depression is more than just feeling low for a while. It is a very real illness, which has symptoms that can make life seem as though it isn't worth living.
Although most sufferers of depression are likely to describe slightly different symptoms, most identify a strong feeling of being enveloped by sadness and hopelessness. Other symptoms may include:
• Lacking motivation
• Feeling tired and lacking energy
• Losing confidence and self esteem
• Being unable to find happiness in things that you usually enjoy
• Experiencing problems sleeping
• Losing your appetite or overeating
• Lacking concentration
• Losing your sex drive
• Having suicidal thoughts
As one of the most common mental health conditions in the UK, depression has affected as many as 1 in 4 people. The good news is that depression is treatable and you don't need to continue to live with the debilitating symptoms any longer.
How does TMS work as a treatment for depression?
The treatment works by stimulating the prefrontal cortex – the area of the brain that controls mood, motivation and social skills. In particular, the left side of the prefrontal cortex is associated with positive feelings. Instead of numbing emotions, as medication can do, TMS treatment gets to the root of the problem by resetting brain patterns and pathways using targeted magnetic pulses.
Research proves TMS to be an effective, safe treatment for depression. Our team of experts have developed treatment programmes for unipolar depression, bipolar disorder, seasonal affective disorder and postnatal depression, with the aim of helping even more patients live a better quality of life, free from the symptoms of depression.
A course of TMS for depression involves 30 sessions of treatment which take place over a period of three to six weeks. Each treatment lasts 30 minutes, and some patients are able to have more than one session a day.
* According to the latest Smart TMS internal audit
* According to the latest Smart TMS internal audit
Depression Treatment Options
The standard treatments offered for depression are a mixture of anti-depressants and talking therapies, such as Cognitive Behaviour Therapy (CBT). If these options don’t work, your GP may refer you to a psychiatrist who can prescribe other treatments, such as Electroconvulsive Therapy (ECT).
Research has shown that Transcranial Magnetic Stimulation (TMS) can greatly improve the quality of life in many patients living with depression.
As shown below, although anti-depressants and ECT work in reducing symptoms for some patients, the side effects can often outweigh the benefits. With higher response and remission rates and fewer, less intense side effects, TMS doesn’t only manage the symptoms of depression, but treats the cause of the condition.
TMS Compared to Other Treatments
✓ NICE approved
✓ Outpatient treatment
✘ Ongoing recovery
Antidepressant Side Effects:
to induce seizure
✓ NICE approved
✘ In patient treatment
✘ Hours/days to recover
ECT Side Effects:
✓ NICE approved
✓ Outpatient treatment
✓ Immediate recovery
TMS Side Effects:
1 in 50,000 risk of seizures
What our patients say
With 60% of our patients going into remission from depression, Dr Neal and his team understand the need to help our patients stay well beyond the end of their TMS treatment. Using research and our own experience, we have designed aftercare packages to suit all.
The Continuous Care maintenance packages available for depression patients include:
- Smart TMS Monthly: A monthly TMS “top up” to keep you feeling your best.
- Smart TMS On-Demand: A membership scheme that entitles you to exclusive discounts should you feel as though you’re relapsing post-treatment
Have you had TMS treatment for depression at another clinic? Smart TMS can offer you maintenance therapy, too!
TMS Depression Treatment Questions & Answers
Transcranial Magnetic Stimulation is an MRI-strength magnetic pulse designed to stimulate the brain.
In depression treatment, the left prefrontal cortex is stimulated. This is the area of the brain that is responsible for mood, emotion and motivation.
Research on depression has shown that that the area of the brain responsible for positive emotions, such as happiness and excitement, and motivation in under active. This area is the left prefrontal cortex. By stimulating this area using TMS, the brain activity is increased and the mood improved.
Following our most recent audit:
- 82% of patients saw a clinically significant reduction in symptoms
- 60% of patients entered full remission following a full course of treatment
The normal protocol is a 30 minute session per day, 5 times a week for 2-6 weeks: the overall duration of the treatment depends on how quickly the patient responds. We do, however, appreciate that this isn't always possible so your patient advisor can work with you to come up with a treatment schedule that fits into your daily life. Our patients typically need around 30 sessions of rTMS to derive the most benefit.
A standard course of TMS treatment for depression takes between 3 and 6 weeks, depending on the individual prescription. Ideally, a course of 30 sessions would be undertaken at a rate of 5 sessions per week for 6 weeks, however in some cases our clinicians will prescribe more than one session per day, resulting in the course being completed more quickly than normal.
TMS therapy is an appropriate treatment for patients over the age of 16 with a depressive disorder.
If you or a loved one has been diagnosed with clinical depression, Bipolar, postnatal depression, seasonal affective disorder or major depressive disorder, then TMS therapy may be able to help.
The majority of patients get a significant improvement in their symptoms from TMS. It is not possible to know which patients will respond so we break the treatment into two courses of 15 sessions. If a patient is not showing any benefit from the first course of TMS, we discuss the chances of further improvement with the patient. At this point, your clinician may suggest an alternative area of the brain for the coil to be placed.
According to research, around 1 in 3 patients are at risk of relapsing. This risk is minimised significantly through maintenance treatment. Learn more about our maintenance package: Continuous Care
rTMS Therapy is a very well tolerated treatment and there are very few limitations as to who can receive it.
However, not all patients are appropriate candidates for rTMS therapy. Patients who have metal implants in their head/neck or a cochlear implant aren't appropriate candidates for rTMS.
A Smart TMS clinician will confirm your suitability prior to writing your rTMS prescription.
If TMS is not the right form of treatment for you, your own doctor will continue to treat you according the NICE Guidelines for the management of depression.
Patients should continue to take antidepressant medication and any other psychotropic medication while receiving rTMS therapy.
We typically recommend 30 sessions of TMS for depression to derive the most benefit from the treatment, although we'll know by the 10th-15th session if you're responding well. Some patients may experience results in less time, while others may take longer.
Antidepressants have numerous potential side effects such as nausea, diarrhoea, insomnia, sedation, lack of emotion, and sexual problems; rTMS has few side effects. The most common side effects of rTMS are a mild headache and tiredness. There is a 1 in 50,000 chance of having a seizure, which is very similar to the possibility of having a seizure from antidepressants.
Antidepressants are systemic, meaning that the medicine enters the body and blood stream; rTMS is non-systemic, meaning that no chemicals enter the body.
While both TMS and Electroconvulsive Therapy (ECT) are effective in the treatment of depression, there are many differences in safety and tolerability.
Both are designed to treat depression through the application of energy into the brain, but the similarities end there.
ECT is a more intensive and invasive procedure than is TMS as ECT requires an anaesthetic and is designed to stimulate a controlled seizure. The main side effect from ECT is memory loss which does not occur with TMS.
By contrast, TMS is an outpatient procedure with few side-effects.
There are a handful of NHS Trusts offering TMS treatment for patients with depression who meet specific criteria. Unfortunately, the waiting lists tend to be long and no one is guaranteed to be accepted for treatment.
The NHS is not offering funding widely for TMS depression treatment currently.
For more information see TMS on the NHS
As rTMS is becoming more and more popular in the UK, more private medical insurance providers are covering the treatment. For more information and to learn which insurers we're registered with, visit: Private Health Insurance
Please see the pricing section of our website: TMS Treatment Pricing
Before you can start treatment, there are two stages that need to be completed:
- Completion of your pre-assessment questionnaire. This gives us the information we need on your medical history and symptoms before your assessment with one of our clinicians;
- Our clinician will talk through your medical history and symptoms before arriving at a diagnosis and confirming your suitability for TMS treatment. A prescription for TMS will be written.
To arrange to start this process, please contact us on 0345 222 5678 or submit an enquiry and one of our patient advisors will contact you.
TMS is a safe and effective treatment for depression and a large majority of patients are suitable to receive it.
With a network of clinics in the UK and Ireland, you are sure to have a clinic within traveling distance of your home. Call our friendly patient advisors to talk more about if TMS is right for you.
Is TMS right for you?
Download our brochure for more details and
your questions answered.
Treatment results may vary from person to person according to individual experience and the condition being treated.