PTSD – Post Traumatic Stress Disorder

Condition

PTSD stands for Post-Traumatic Stress Disorder. This is an anxiety disorder caused by events which are very stressful, upsetting, frightening or distressing.

It is normal to be upset by difficult life events. Often you feel numb for a while, then emotions and physical reactions emerge. This is hard, but normally passes within a month or two.

Where these symptoms continue or become very extreme, then there may be a diagnosis of PTSD.  This can also emerge years after the event.

PTSD is thought to affect around a third of people who have a traumatic experience.

Signs and Symptoms of PTSD

  • Difficulty sleeping – insomnia, nightmares, broken sleep
  • Anxiety, worry, feeling on edge
  • Flashbacks
  • Negative thoughts
  • Constantly reviewing the event
  • Avoiding reminders of the event
  • Emotional numbing
  • Irritability
  • Anger, aggression
  • Difficulty concentration
  • Depression, anxiety, phobias
  • Headaches, chest pain, stomach ache
  • Prone to self-harm, excessive alcohol intake, drug misuse

Causes/Triggers

PTSD tends to come from a specific and major event or experience. Examples include:

  • Military combat
  • Witnessing or being a victim of assault, mugging, robbery
  • Abuse (sexual, emotional, physical)
  • Terrorism
  • Natural disasters
  • Accidents

The circumstances for each patient are different.

Conventional Treatments

The main treatment routes are:

  • Psychotherapy – talking therapies, counselling
  • CBT – cognitive behaviour therapy
  • Medication – antidepressants
  • Monitoring the patient

rTMS at The Smart Clinics in London

On the basis of research, we believe that rTMS – Repetitive Transcranial Magnetic Stimulation could offer sufferers of PTSD an alternative treatment option, using transcranial magnetic stimulation to work directly on the associated areas of the brain.

It would offer the benefit of being a non-medication approach, avoiding potentially unpleasant side-effects associated with drugs.

Transcranial Magnetic Stimulation therapy treatment is available at Smart TMS, based at The Smart Clinics, Brompton Cross, London. Smart TMS was the first UK clinic to offer treatments for anything other than depression.

To discuss this further, please contact us.

Post-Traumatic Stress Disorder and TMS Treatment

Research and Studies

There is scientific evidence that rTMS is effective and safe for the treatment of PTSD.

Research Studies

In a case series the authors systematically examined the clinical and safety outcomes in 10 patients with comorbid MDD and PTSD syndromes who received 5-Hz rTMS therapy. Results showed a significant reduction in the symptoms of PTSD and major depression. 8/10 with PTSD showed a significant reduction in symptoms. Stimulation was well tolerated and there were no serious adverse events. These data indicate 5-Hz rTMS may be a useful option to treat PTSD and co-morbid depression (Philip et al, 2016).

A study reviewed randomized and sham-controlled trials of rTMS treatment for PTSD from 1995 to March 2013. Studies on rTMS applied to the right DLPFC included 64 adults with PTSD. Statistical analysis showed significant and large-sized differences in outcome favouring active rTMS. Also, there were significant pre and post decreases with active rTMS in overall anxiety and depressive symptoms. Dropout rates at the study end did not differ between active and sham rTMS groups. Regarding rTMS applied to the left DLPFC, there is only one study published to date (using a high frequency protocol), and its results showed that active rTMS seems to be superior overall to sham rTMS. This exploratory meta-analysis showed that active rTMS applied to the DLPFC seems to be effective and acceptable for treating PTSD (Berlim et al,2014).

One study aimed to investigate the efficacy of 20 Hz repetitive transcranial magnetic stimulation (rTMS) of either right or left dorsolateral prefrontal cortex (DLPFC) as compared to sham rTMS for the relief of posttraumatic stress disorder (PTSD)-associated symptoms. This was a double-blind, placebo-controlled trial with 30 patients with DSM-IV-diagnosed PTSD. They were randomly assigned to receive 1 of the following treatments: active 20 Hz rTMS of the right DLPFC, active 20 Hz rTMS of the left DLPFC, or sham rTMS. Treatments were administered in 10 daily sessions over 2 weeks. Both active conditions-20 Hz rTMS of left and right DLPFC-induced a significant decrease in PTSD symptoms as indexed by the PTSD Checklist and Treatment Outcome PTSD Scale; however, right rTMS induced a larger effect as compared to left rTMS. In addition, there was a significant improvement of mood after left rTMS and a significant reduction of anxiety following right rTMS. Improvements in PTSD symptoms were long lasting; effects were still significant at the 3-month follow-up. Finally, neuropsychological evaluation showed that active 20 Hz rTMS is not associated with cognitive worsening and is safe for use in patients with PTSD. These results support the notion that modulation of prefrontal cortex can alleviate the core symptoms of PTSD and suggest that high-frequency rTMS of right DLPFC might be the optimal treatment strategy (Boggio et al, 2010).