The new buzz about depression

Louise’s battle with depression started when she was 15. ‘One day I was fine and the next I couldn’t stop crying. There didn’t seem to be a specific trigger. There is a lot of depression in my family so I suspect I inherited a tendency to it,’ she says. Over the next 20 years, Louise, now 36, tried 12 different types of antidepressant, which made her feel worse. ‘One gave me such severe continued insomnia that for the first time I felt suicidal. I faced every day feeling like the most worthless creature ever.’

Louise also tried acupuncture, exercise and talking therapies, all in vain. ‘By my 30s life had become unbearable,’ she says. In 2013, she went as a day patient to a psychiatric hospital, and it was here that another patient mentioned a treatment called repetitive transcranial magnetic stimulation (rTMS).

Louise says, ‘rTMS saved my life.’ Consultant psychiatrist Dr. Rafael Euba, who treated Louise at The London Psychiatry Centre in early 2014, explains that up to two thirds of people with depression continue to suffer with symptoms despite being treated with antidepressants and talking therapies. ‘rTMS is an effective treatment for intractable depression,’ says Dr. Euba, who has treated over 100 patients.

‘The brain communicates through electrical messages,’ he explains. ‘Brain-imaging techniques show that patients with depression often display underactivity in the areas that regulate mood [the left frontal part of the brain and the limbic system]. rTMS increases the number and frequency of the messages in these areas.’ In 2008 it was approved by the US Food and Drug Administration. Dr. Euba, who also works in the NHS, trained in America before setting up his UK centre.

A magnetic field is created by passing pulses of electrical current through a coil of wire, encased in plastic and put close to the left side of the head, a few inches above the temple. ‘It’s like having a woodpecker tapping at your head but it doesn’t hurt,’ says Louise. The only side effects are a temporary mild headache or nausea, with a very rare risk of seizure in patients who are on medication (under one patient in 3,000).

The UK National Institute for Clinical Excellence (Nice) says there are no major safety concerns associated with rTMS, but in 2007 said that ‘there is uncertainty about the procedure’s clinical efficacy’ and called for more research (which is ongoing in the US and UK). However, a 2013 review in the Psychiatric Times that ‘current available evidence for the use of rTMS in depression supports its efficacy for the treatment of acute depressive episodes’.

Treatment involves a daily session five days a week over a four-to-six week period, with maintenance sessions every one to three months. The downside is the cost of about £2,000 a week (it’s sometimes available on the NHS). Louise’s parents helped fund her treatment and some insurance companies will cover it.

For the first three weeks Louise noticed no difference, ‘then in the fourth week I suddenly started feeling better. I went from feeling suicidal to normal in five weeks.’ A year on, Louise has had no recurrence of the  ‘deep horrible depression’. The London Psychiatry Centre can be contacted at 4224


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