UK Health Radio’s Sunshine UKay Health Show interviewed Dr Leigh Neal about rTMS – Repetitive Transcranial Magnetic Stimulation.
Dr Neal explained the background to rTMS treatment, which was invented in Sheffield in the 1980s and has been subject to a lot of research before entering mainstream use for treating depression.
Dr Leigh A Neal, Consultant Psychiatrist and Medical Director at Smart TMS in London, explains the treatment:
“What it is basically is a very strong magnet which pulses at different frequencies and it’s held up against the head. It’s been subject to a great deal of research in psychiatric treatment and was approved by NICE in December 2015 for the treatment of depression, for which it was found to be effective in numerous studies.”
“It was found to be effective in treating resistant depression in about 30-40% of cases.”
Dr Neal explains that depression is very common.
- At any one time, about 4% of the population has a major depressive order
- Throughout people’s lifetimes, about 30% of people will suffer from a depressive episode in their life
Presenter Kirsty Ashton comments that rTMS is not yet widely available in the UK, being in just 2 NHS trusts and some private clinics. She asks Dr Neal how people can access the service if they want/need it.
Dr Neal responds:
“It’s interesting to compare the situation in the USA. The FDA approved TMS in the USA in 2008 and in the 8 years following that, the number of clinics there grew from zero clinics to 1,200 clinics; so we’re probably quite early on in the evolution for TMS in this country, although it’s quite widely available on the continent.
“At the moment there about 4-5 private clinics in the UK with 3 being based in London. There’s one major NHS centre in Northampton which has been doing TMS now for about 2 years and we’ve got very close links with them, we share our clinical data.
“There are one or two other trusts that are developing the service, but they’re at the very early stage; so there aren’t many people in this country at the moment offering the service.
NHS Northamptonshire Trust Partnership
The presenter asks what the link with the Northamptonshire Healthcare NHS Foundation Trust partnership means. Dr Neal explains:
“From my personal point of view as a Consultant Psychiatrist, I’ve got very close liaisons with Dr Alex Kerr O’Neil, who’s the Lead Psychiatrist for TMS in the Trust and we’re able to share our knowledge and our experience, which helps us both improve our practice and the delivery of the service to our patients.”
Kirsty asked about the improvements patients had seen and how long they’d remained in remission for. Dr Neal replied:
“We’ve treated about 20 people so far with various differing conditions and we’ve completed treatment for major depression in 11 patients and 82% – that is 9 of those patients – went into complete remission, so they were fully recovered from depression and of those patients that recovered, their symptoms reduced by 75% on average; so we’ve had extremely good results. Much better in fact than the published research would expect to achieve.”
The interview discussed how treatment compares to antidepressant tablets to help people who are living with depression. Leigh explained:
“The mainstays of treatment of depression are psychological treatments like CBT and antidepressants; and antidepressants are generally very effective in the treatment of depression. I’ve been treating patients with antidepressants for many years and there’s certainly a difference in the way people respond to TMS from the way they respond to treatment with antidepressants.
“We’ve noticed that with TMS, people have a great deal more positivity and they’re more motivated, they’re more sociable; and they don’t have the slight numbing effect that you get as a side effect of antidepressants and they’re certainly happier with the way that they respond than the way most people respond with antidepressants.
Dr Neal explains that most of the patients they treat have chronic depression and have been depressed for many years. They have generally already ‘been through the mill’ with antidepressants and will also have tried psychological treatment and want to try something else.
However, as appropriate to the patient, Smart TMS will explain the range of treatment options – psychological treatment, antidepressant medication or rTMS and see which they want to have treatment with first.
Dr Neal explains that TMS is not normally the first line of treatment. NICE depression guidelines produced in 2010 state that the first line of treatment with any depressive illness should be psychological treatment, then you would normally try one or two antidepressants first. However, where a patient was against other treatments, TMS may be offered as an alternative solution.
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DR LEIGH A NEAL MD FRCPSYCH
Dr Leigh A Neal is a consultant psychiatrist and Medical Director of Smart TMS, a London-based clinic offering Repetitive Transcranial Magnetic Stimulation – a non-medication-based mental health treatment.
He has been a Consultant Psychiatrist for over 20 years with a career including work within the Armed Forces, NHS and Independent Sector.
SMART TMS CLINICS
Smart TMS is a specialist provider of TMS treatment in London. Repetitive Transcranial Magnetic Stimulation therapy (rTMS) is a technological breakthrough in the treatment of depression with a variety of further potential treatment applications.
Smart TMS is located within The Smart Clinics in South Kensington/Brompton Cross.
For any queries or to book an appointment, please contact us:
Tel: 0800 088 6060