Repetitive Transcranial Magnetic Stimulation (rTMS)

Repetitive Transcranial Magnetic Stimulation (rTMS) is the latest effective, non-pharmacological treatment for depression in the UK and is being delivered at Nightingale Hospital in partnership with MagnaCentre.

Read the latest NICE guidance published December 2015.

How does Repetitive Transcranial Magnetic Stimulation (rTMS) help?

Living with the symptoms of depression can be very debilitating and approximately a third of patients with depression do not respond to treatment. This is known as ‘Treatment Resistant Depression (TRD)’ ( i.e. where antidepressants and talking therapies have failed).

For patients suffering in this way, rTMS is a significant, new treatment option.

The basic principle of rTMS is to target short magnetic pulses over the scalp to produce electrical currents in specific brain regions that regulate mood.

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). Furthermore, it is becoming increasingly used in Scandinavian and other European countries.

Benefits of rTMS:

  • It is highly effective in treating depression
  • It is a long lasting treatment with minimal side effects
  • Treatment is well tolerated by most people
  • Unlike Electroconvulsive Therapy (ECT), it does not require anaesthesia or lead to memory impairment.
  • Daily activities can be resumed immediately after each session
  • Can drive straight after treatment

What happens in Repetitive Transcranial Magnetic Stimulation (rTMS) treatment?

An electromagnetic coil, or ‘stimulator’, which is encased in a protective plastic casing, is placed over the targeted region of the patient’s scalp. Before treatment begins, the specialist practitioner will identify the ideal location for the magnets to be placed and the best dose of magnetic energy for each individual.

The electromagnetic coil is switched on and off repeatedly to produce stimulating pulses. This results in a tapping or clicking sound that usually lasts for a few seconds, followed by a pause. Patients may also feel a tapping sensation on their forehead.

The electro-magnetic field generated is freely and painlessly able to pass through the skull, generating electrical pulses in the targeted underlying brain tissue.

The initial session will last an hour. This is to complete all initial paperwork and locate the ideal position for the electromagnet to be placed. Subsequent sessions last around 20 minutes, but at Nightingale Hospital, they advise patients to allow 40 minutes for each session.

Repetitive Transcranial Magnetic Stimulation (rTMS) at Nightingale Hospital London

The rTMS service at Nightingale Hospital operates using an ‘H’ coil (developed following research at the National Institute of Mental Health, USA). This is the latest form of rTMS and is reported to stimulate deeper, limbic, brain regions – in addition to the limited stimulation of superficial regions targeted by earlier types of coil (e.g. the figure of 8 coil). Click here for further information on rTMS with the ‘H’ coil.

Nightingale Hospital, in partnership with MagnaCentre, delivers rTMS on an outpatient, day patient or inpatient basis. To understand the most suitable arrangement for your needs and personal circumstances, call their Patient Services Team on +44 (0)20 7535 7705, who will be very happy to answer any questions you have.

Is Repetitive Transcranial Magnetic Stimulation (rTMS) treatment right for you?

rTMS may be right for you if you:

  • Have failed to respond to pharmacological treatment
  • Have failed to respond to talking therapies
  • Are unable to tolerate the side effects of anti-depressants
  • Do not want to have Electroconvulsive Therapy
  • Suffer from postnatal/postpartum depression and wish to breastfeed but avoid the transmission of anti-depressant medication.

rTMS is not suitable:

  • For those with co-morbid neurological disorders, history of epilepsy, stroke, and/or neurosurgery.
  • For those who have metal plates in the head / brain, the presence of pacemakers or other electronic implants, inner ear implants, metal or magnetic objects in the brain and medication pumps
  • For people with alcohol and / or drug dependency
  • Age below 18 years
  • Those suffering from other mental health disorders such as anxiety, bipolar, eating disorders.

But what are the results of rTMS?

There is an ever-expanding literature of research providing an evidence base supporting the benefit of deep TMS using the H-coil. Please read more here.

Please contact Nightingale Hospital confidentially on +44 (0)20 7535 7705, 24 hours a day or enquire online

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