Depression – rTMS treatment

Depression

According to the World Health Organization (WHO), depression is the most common mental health disorder globally and a leading cause of disability and workplace absenteeism. More than 300 million people of all ages are affected by this condition worldwide.

Approximately one in ten patients visiting a general practitioner for various complaints suffers from full-blown depression, with many others reporting sub-clinical depressive symptoms. Patients may experience profound sadness, feelings of numbness, pervasive emptiness, and unrelenting anxiety. Physical symptoms often include sleep and appetite disturbances, headaches, constipation, and psychomotor retardation (slowness of movement and thought).

While conventional pharmacological treatments and psychotherapeutic interventions are effective for many, approximately 20% of patients do not achieve satisfactory resolution of their symptoms despite treatment. In other instances, pharmacotherapy may be difficult to tolerate due to side effects or pre-existing physical health conditions. In such cases, repetitive Transcranial Magnetic Stimulation (rTMS) offers a safe, well-tolerated, and effective non-invasive treatment option.

What is Repeated Transcranial Magnetic Stimulation (rTMS)?

rTMS is a non-invasive, painless procedure recognized as an established treatment for depression. Approved by the US Food and Drug Administration (FDA) in 2008 and validated by the National Institute for Health and Care Excellence (NICE) in 2015, it is now standard clinical practice in both the United States and Europe. This method is particularly beneficial for individuals who have not responded sufficiently to medication or who struggle with poor treatment tolerance. rTMS can be safely used in combination with antidepressants and psychotherapy.

How does rTMS work?

The rTMS system generates a strong, focused magnetic field that penetrates the skull to stimulate the cerebral cortex. This process activates neurons and their synapses, modulating neurotransmitter activity, receptor sensitivity, neuroplasticity, and neurogenesis—the formation of new synaptic connections. In this way, rTMS exerts a biological effect comparable to that of antidepressant medication.

What is the treatment procedure?

The standard therapeutic protocol consists of five sessions per week over a period of four weeks. Each session lasts approximately 40 minutes. For the majority of patients, noticeable improvements typically emerge after 10 to 12 sessions.

In our clinic, we adhere to international clinical guidelines. We typically perform 20 sessions (five per week), with the option to extend the therapy to 30 sessions if clinically indicated. Patients are regularly monitored throughout the process, which helps determine the final number of sessions required.

During a session, the patient sits in a comfortable reclining chair. A coil is positioned over the targeted area of the brain. The coil generates rapid magnetic pulses, which the patient may feel as a tapping sensation on the scalp accompanied by a clicking sound. The procedure is painless; patients can listen to music, watch a film, or relax during the session. Afterward, patients can immediately drive and resume their daily activities.

Safety is our priority: medical qualification is mandatory before starting therapy, and all procedures are performed by qualified personnel under the supervision of an experienced physician.

Who should avoid rTMS?

While most patients experience no side effects, rTMS is contraindicated for individuals with a history of epilepsy or conditions that increase the risk of seizures. It is also unsuitable for those with certain surgically implanted metal objects in the head or neck area.

Contraindications include:

• Aneurysm clips or coils
• Bullet fragments or shrapnel near the head
• Cardiac pacemakers or implantable cardioverter defibrillators (ICD)
• Facial tattoos containing magnetic or metal-sensitive ink
• Implanted stimulators
• Metal implants in the ears or eyes
• Stents in the neck or brain

What are the possible side effects of rTMS?

rTMS does not cause pain, though some patients describe the sensation of magnetic pulses as uncomfortable—often feeling like a knocking or tapping. Electromagnetic pulses may also cause temporary muscle twitching or tingling in the face or scalp.

Common mild-to-moderate side effects include:

• Lightheadedness
• Mild headaches
• Tingling in the face, jaw, or scalp (While rare, there is a small, documented risk of seizures.)

Consultation and treatment costs

On the day your rTMS treatment begins, a psychiatrist will conduct a formal assessment to ensure the treatment is appropriate and safe for your specific needs. This assessment is required even if you have undergone rTMS elsewhere. The cost of this initial consultation is included in the total price of the therapy.

If you have further questions or wish to schedule a consultation with an experienced psychiatrist, please contact us via email, phone, or by using the contact form on our website.

Questions are answered by our expert: Jakub Kaźmierski, MD, PhD

• Phone: +48 698 648 521
• E-mail: medart.centrumpsychiatrii4@gmail.com

LOCATION

• Our clinic is discreetly and conveniently situated in Łódź, Poland, located very close to the city centre.
• Specialists: We offer world-standard diagnosis and treatment provided by qualified and experienced English-speaking specialists.
• Accommodation: As Poland’s third-largest city, Łódź provides a wide range of reasonably priced accommodation, from studios and privately owned apartments to both basic and luxury hotels. Many of these options are located in historic buildings and offer excellent value.
• Accessibility:
  • By Air (Łódź): The local airport is 6km from the city centre and is serviced by low-cost airlines like Ryanair, with flights to destinations in the UK, Ireland, and continental Europe.
  • By Air (Warsaw): An easy alternative is flying to Warsaw Chopin Airport or Warsaw Modlin, which offer fast and frequent 1.5-hour train connections to Łódź.
• Recognition: In 2019, LONELY PLANET named Łódź as one of the top 10 value destinations.

Would you like help with anything else regarding your travel to the clinic?

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.