Depression – rTMS treatment

Depression

According to the World Health Organization (WHO), depression is the leading cause of disability and inability to work in the world and the most common mental disorder. Globally, more than 300 million people of all ages suffer from this disease.

Every tenth patient visiting a GP for different symptoms has a full-blown depression, and others report depressive symptoms. Patients suffering from depression may experience severe, unjustified sadness, depression and numbness as well as subjective suffering and relentless anxiety. There are also disturbances of sleep, appetite, headaches, constipation, slowness of movement and thinking. Available drugs and psychotherapeutic interventions usually allow to reduce depressive symptoms. Unfortunately, despite the treatment, it is not possible to achieve satisfactory improvement and resolution of complaints in about 20% of patients. In other cases, pharmacological treatment is difficult due to physical condition of individuals and side effects after medications.

In such a situation, non-invasive transcranial magnetic stimulation of the brain (abbreviated as rTMS) may be an effective, well-tolerated and safe form of depression treatment.

What is Repeated Transcranial Magnetic Stimulation (rTMS)?

rTMS is a non-invasive, painless and effective treatment for depression. It was approved by the US Food and Drug Administration and NICE (National Institute for Health and Care Excellence) in 2008 and 2015, respectively, and it is now a recognized treatment for depression both in the United States and in Clinical Centres in Europe. This method may be of particular use in people who have not been improved after drug treatment or when drugs have been poorly tolerated. Antidepressants and psychotherapy may be used in combination with rTMS.

How does rTMS work?

rTMS is a non-invasive procedure. The system generates a strong magnetic field which has the ability to penetrate through the skull to cerebral cortex. As a result, neurons and their synapses are stimulated. The therapy gives benefits by affecting the activity of neurotransmitters (natural substances responsible for the proper functioning of the brain), receptor activity, neuroplasticity and neurogenesis (the formation of new synaptic connections). In this way, it works just like antidepressants.

What is the treatment procedure?

The therapeutic effect is achieved by applying five therapy sessions a week for a period of 4 weeks. Each therapy session lasts 40 minutes. For the majority of patients, a noticeable effect of rTMS is usually apparent after 10 to 12 sessions.

In our Clinic, we use the rTMS procedure in accordance with global, international guidelines. We carry out 20 therapeutic sessions (5 sessions a week), with the possibility of extending the therapy to 30 sessions if it is individually indicated. As patients progress through their therapy, they are regularly assessed and this may determine the eventual number of sessions. Antidepressants and psychotherapy may be used in combination with rTMS treatment.

During rTMS session the patient sits in a comfortable reclining chair with a coil placed above the appropriate part of the brain for the treatment session to commence. This coil generates rapid magnetic pulses that feel like a tapping on the scalp and make a clicking sound. As they are not painful, during each session patients can listen to music, watch a film or simply sit back and relax, and after the session drive and resume their normal day.

rTMS is a safe method of treatment, the medical qualification is carried out before the therapy, and the therapy itself is carried out by qualified personnel, under the supervision of a experienced physician.

Who should avoid rTMS?

The majority of people using rTMS do not suffer from any side effects. The treatment can be dangerous if you have a history of epilepsy or any condition or medication increasing the risk of seizures. It is also not suitable for people with any surgically implanted metal work in the brain or neck.

People who shouldn’t get rTMS include those with:

• aneurysm clips or coils
• bullet fragments or shrapnel near the head
• cardiac pacemakers or implantable cardioverter defibrillators (ICD)
• facial tattoos that have magnetic ink or ink that is sensitive to magnets
• implanted stimulators
• metal implants in the ears or eyes
• stents in the neck or brain

What are the possible side effects of rTMS?

Pain isn’t a side effect of rTMS. However, people may describe the sensation of the magnetic pulse as uncomfortable. Some people describe this as a knocking or tapping feeling. The electromagnetic pulses can cause muscles in the face to tighten or tingle.

The procedure is associated with mild to moderate side effects, including:

• feelings of lightheadedness
• mild headaches
• tingling in the face, jaw, or scalp

Though rare, rTMS does come with a small risk of seizures.

Consultation and treatment cost

On the day the rTMS treatment starts, an assessment is carried out by a psychiatrist to confirm that the treatment is appropriate and safe for you. This assessment is required even if you have previously been treated for rTMS. The cost of the consultation is included in the therapy cost.

Should you have any further questions regarding the therapy itself, or require a consultation with an experienced psychiatrist, please do not hesitate to contact us via email, phone or fill in the contact form. The questions will be answered by our expert Jakub Kaźmierski, MD, PhD. +48 698 648 521 e-mail: medart.centrumpsychiatrii@gmail.com

OUR LOCATION

Our clinic is a tranquil and welcoming space where we focus on providing you with the highest level of care and treatment. We look forward to seeing patients from all over Poland and other European countries. Here you will find qualified and experienced English-speaking specialists offering world-standard diagnosis and treatment of psychiatric conditions.

The clinic is discreetly and conveniently located in Łódź, Poland, very close to the city centre. Łódź – Poland’s third-largest city offers a wide range of accommodation possibilities at more-than-reasonable prices. You can choose from small privately owned apartments, studios, basic hotels to luxury ones. All are excellent value compared to other big cities, and many are housed in interesting historic buildings.

Łódź is easily accessible by plane. Its small airport is 6km of the city centre. It’s serviced by low cost airlines, including Ryanair, and there are scheduled flights to destinations in the UK and Ireland (London Stansted, East Midlands and Dublin) and continental Europe (Munich and Athens). An easy alternative is flying to Warsaw (Warsaw Chopin Airport and Warsaw Modlin) as there are frequent and fast train connections with Łódź (1,5-hour journey).

LONELY PLANET has announced Łodź as one of the top 10 value destinations in 2019.

You can find out more about our city here:

As the city has a lot to offer, it provides a relaxing environment in which you can focus on your recovery away from the stresses and strains of day-to-day life at home.