An innovative new treatment to help individuals with drug-resistant depression is launched at Camden and Islington NHS Foundation Trust.
The Transcranial Magnetic Stimulation device uses a pulsating magnetic field to target specific sites in the brain, stimulating nerve cells in those areas, thereby easing symptoms of depression.
A recent US study* found that daily TMS sessions for six weeks led to remission rates of between 50%-70% in people whose depression had previously been untreatable with drugs, with 80% of this group still in remission four years later.
C&I is the first NHS Mental Health Trust in London and the south of England to start a Clinical TMS service as part of a Clinical Neuromodulation Service. TMS as a treatment for depression was pioneered by Dr Mark S. George who is a Distinguished Professor of Psychiatry at MUSC (Medical University of South Carolina).
He discovered that the machine, which makes a rhythmic tapping sound similar to an MRI scan, strengthened circuits in the brain in a similar way to how weightlifting stimulates and strengthens muscles in the body.
The magnetic field produces currents in nerve cells in the prefrontal cortex of the brain, bulking up the area and leading to new nerve cells being made and new circuits turned on. This, in turn, can result in a lifting of depression.
Dr Mohamed Abdelghani, the consultant psychiatrist at Camden and Islington NHS Trust, who is leading on the project, spent two weeks in South Carolina with Professor George undergoing intensive training to carry out the procedure.
Dr Abdelghani said: “treatment-resistant depression is one of the hardest conditions to treat, affecting one-third of service users who suffer with depression and blighting lives for many, many years.
“This is a revolutionary treatment which has been shown to increase recovery rates in patients who either cannot tolerate drug treatment or who have seen no improvement in their condition with the use of medication. An additional benefit is that there are no systemic side-effects, unlike most drug treatments.”
It is expected that the new device will be in use by July. For the initial stage of the service, the treatment will be limited to patients under the care of the Complex Depression Anxiety and Trauma service.
* A recent study presented at the 2016 Annual Meeting of the American Psychiatric Association (APA) in Atlanta, Georgia, investigated the effects of TMS on depressive symptoms in a private practice setting. Patients demonstrated a 76.4% to 78.8% [positive] response to treatment. Remission rates were between 52.5% and 72.4%, and of these patients, an 80% long-term remission rate was observed among those available for follow-up assessments over a period of more than 4 years.
C&I has moved the service we normally offer in emergency departments to our 24-hour Mental Health Crisis Assessment Service, at St Pancras Hospital. The service will see people in need of urgent care so that they do not have to go to a hospital emergency department unless they have an urgent medical need. Emergency departments are under unprecedented pressure due to COVID-19 – the illness caused by coronavirus. We are urging people in mental health crisis to telephone our 24/7 crisis line on 0800 917 3333 or contact their usual community mental health team. If service users attend the 24-hour Mental Health Crisis Assessment Service in person we will see you but we urge you to contact the crisis line in advance for advice to ensure you are only leaving home when absolutely necessary.