Repetitive transcranial magnetic stimulation (rTMS) is an innovative and evidence-based approach that’s revolutionising the treatment landscape for depression and OCD. rTMS is getting increasing attention for its non-invasive nature and effectiveness in alleviating symptoms of these mental health conditions.
In this guide, we delve into how rTMS therapy works, how effective it is, and address safety considerations.
During an rTMS session, electromagnetic coils are placed on your scalp in order to deliver magnetic pulses to your brain. rTMS specifically targets areas of the brain that are involved in mood control, which means it can help to alleviate the symptoms of your mental health conditions, and improve wellbeing.
“rTMS is a novel and very promising treatment for depression and is safe and effective. It's particularly useful where other treatment approaches haven't worked and has fewer adverse effects than other pharmacological or physical treatments.”
Depression is treatable, but for some, standard methods like medication and psychotherapy may not provide relief. In such cases, repetitive transcranial magnetic stimulation (rTMS) can be a viable option.
It is also used to treat conditions like OCD, migraines, and even to help individuals quit smoking, especially when other treatments have been unsuccessful.
Recent studies have provided compelling evidence supporting the effectiveness of rTMS as a treatment for depression and OCD.
Study title | Summary of findings | Year |
Comparative efficacy and acceptability of neuromodulation procedures in the treatment of treatment-resistant depression: a network meta-analysis of randomised controlled trials
| rTMS was demonstrated as being an effective treatment method for patients with TRD, while also being well-tolerated. | 2021 |
An update on the clinical use of repetitive transcranial magnetic stimulation in the treatment of depression | rTMS was shown to be an effective, safe and well-tolerated method for treating depression. rTMS also demonstrated effectiveness in treating patients with varying levels of TRD.
| 2020 |
Is rTMS effective for anxiety symptoms in major depressive disorder? An efficacy analysis comparing left-sided high-frequency, right-sided low-frequency, and sequential bilateral rTMS protocols
| rTMS was found to be effective in treating anxiety and depression symptoms associated with major depressive disorder. | 2019 |
Comparative efficacy and acceptability of electroconvulsive therapy versus repetitive transcranial magnetic stimulation for major depression: A systematic review and multiple-treatments meta-analysis
| rTMS is the best tolerated treatment for major depressive disorder, over and above other treatment, such as electroconvulsive therapy (ECT). rTMS as a treatment method for depression, appears to have the most favourable balance between efficacy and acceptability, when compared to other methods.
| 2017 |
Study title | Summary of findings | Year |
A double blind randomised clinical trial of the effectiveness of low frequency rTMS over right DLPRC or OFC for treatment of obsessive-compulsive disorder | rTMS has a therapeutic effect on OCD symptoms. | 2022 |
Repetitive transcranial magnetic stimulation for obsessive-compulsive disorder: a meta-analysis of randomised, sham-controlled trials | The effects of active rTMS remain significantly superior to those of sham 4 weeks after treatment.
| 2021 |
Efficacy and clinical predictors of response to rTMS treatment in pharmacoresistant obsessive-compulsive disorder (OCD): a retrospective study | Patients’ scores in the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) were significantly decreased following rTMS treatment. | 2020 |
Transcranial magnetic stimulation in the treatment of obsessive-compulsive disorder: current perspectives | rTMS shows promise as part of a toolbox of current psychiatric treatment options for OCD. | 2018 |
Some studies have also explored the effectiveness of rTMS in specific populations, such as people with postnatal depression and bipolar depression, as well as in younger and older patients, with promising results. These findings underscore the diversity of research surrounding rTMS and its potential to offer relief for people across different demographics and clinical presentations.
During an rTMS session, you can expect a comfortable and non-invasive experience that lasts for between 15 to 45 minutes, depending on what’s been recommended for you. Here’s what usually happens:
Before the session begins, you’ll be comfortably seated in a chair, and our rTMS technician will ensure that you’re in the best position for stimulation.
A small electromagnetic coil will be placed gently against your scalp in a targeted area. The technician will adjust the electromagnetic coil to make sure this is positioned as precisely as possible.
Once the coil is in place, the technician will start delivering magnetic pulses to your brain. You may hear clicking sounds and feel a tapping sensation on your scalp during the stimulation, but it shouldn’t be painful.
You won’t need to be sedated or receive any pain relief during the sessions. You’ll remain fully conscious and alert throughout the entire session, meaning you can chat to the technician, read, scroll through your phone or tablet, or watch a TV programme.
If you’re receiving rTMS for OCD, the practitioner will also use what are known as ‘provocations’ during the session.
Provocations are actions that are intended to deliberately trigger your OCD symptoms. This helps to activate the brain areas that are involved in OCD, making the rTMS treatment more effective by targeting these regions when they’re active.
For example, if your OCD centres on fears of contamination, you might be asked to imagine touching a dirty surface, or even physically touch an object you think of as being ‘unclean’. This provocation activates the neural circuits associated with your OCD, which the rTMS can then target more effectively. Research shows that these provocations can significantly improve treatment outcomes. While the idea of provocations in rTMS treatment for OCD might sound unpleasant and daunting, rest assured that they’re conducted in a controlled environment under the supervision of a trained practitioner, ensuring your safety and comfort throughout the process.
After the session is complete, you won’t need a recovery period or any downtime. You can go about your day as usual, including driving or returning to work.
Overall, rTMS sessions are designed to be comfortable and well-tolerated, offering a convenient and effective treatment option for depression and OCD. If you have any concerns or questions about the sessions, we’ll be happy to address them and ensure you feel informed and supported.
At Priory, our rTMS experts are here to provide guidance, support and personalised care every step of the way. With its non-invasive nature, minimal side effects and promising efficacy, rTMS offers hope for people seeking relief from depression and OCD symptoms. In addition, due to its convenience as an outpatient procedure and its ability to safely complement other treatment modalities, this innovative approach holds significant potential as a valuable addition to the landscape of depression and OCD care.
Contact Priory today to discuss how rTMS could make a positive difference in your journey towards mental wellness.
I've experienced treatment-resistant depression for almost 10 years now and gave rTMS a try after medication wasn't working as effectively as I'd hoped.
The staff were really professional and accommodating throughout the whole process, and thankfully, I didn't experience any side effects.
I've started to feel better than how I was before I started the treatment, having many more positive days.
Each rTMS session costs £280.
rTMS takes place on an outpatient basis and a single course of treatment usually lasts for 6 weeks. In order for this to be as effective as possible, you’ll need to attend our wellbeing centre for 4 or 5 consecutive days per week. Each session lasts for between 15 to 45 minutes, depending on the specific treatment protocol that’s been prescribed for you.
rTMS at Harley Street can be self-funded (meaning you pay for this yourself), or it can be accessed through private medical insurance. Please check with your insurer for eligibility.
rTMS has been shown to be a safe treatment option for depression and OCD, offering a welcome alternative to more invasive procedures. Unlike some medical interventions, you don’t need to be sedated or receive anaesthetic during an rTMS session, and you’ll remain fully conscious throughout. rTMS is also safe during pregnancy and while breastfeeding, providing a useful option for people who don’t want to take antidepressant medications while they’re pregnant or in the postpartum period.
While rTMS is tolerated well by most people, there are some conditions that might mean someone can’t receive rTMS, or would benefit from additional monitoring if they were to go down this route. These conditions include:
For more information on these potential exclusions, please visit our rTMS FAQs section.
In terms of rTMS side effects, these tend to be mild and brief, and many people don’t experience any side effects at all. Some of the most common side effects include a mild headache, local skin warming and mild scalp discomfort.
Importantly, you’ll be able to resume your usual activities immediately after an rTMS session, including driving and returning to work, without any impairment. These factors collectively contribute to the appeal and accessibility of rTMS as a safe and effective treatment option.
Like lots of mental health treatment approaches, the timeline for experiencing the therapeutic effects of rTMS can vary from person to person. Some people may notice improvements in their depression and OCD symptoms within the first few weeks of starting treatment, while for others, it may take a few months to observe significant changes.
Additionally, factors such as the severity of your condition, your individual response to the treatment, and how well you stick to the treatment plan can all influence how quickly you feel relief from your symptoms.
It's important to remain patient and consistent with this treatment, as the cumulative effects of rTMS often become more pronounced over time. Our rTMS specialists at Priory are highly experienced and can provide personalised guidance and support throughout the treatment process.
Unfortunately, rTMS isn’t a permanent solution and its positive effects can begin to diminish over time. However, the positive effects can last for up to 12 months without any maintenance. This can vary from person-to-person depending on how severe their depression is. We are happy to discuss ongoing maintenance treatment with you, following your initial course of treatment.
rTMS and TMS are similar in a sense that they’re both non-invasive treatment methods that use electromagnetic pulses to stimulate areas of the brain. However, there are some key differences between the two:
rTMS is very safe and is tolerated well by most people. However, there are a number of conditions that might mean someone can’t receive rTMS, or might mean they need closer monitoring or adjusted treatment. These will be discussed at length during an initial assessment with a psychiatrist, to make sure any possible adjustments are made. These conditions include:
rTMS is safe during pregnancy and is a good option for someone who doesn’t want to take antidepressant medication while they’re pregnant.
Yes, you can repeat rTMS. A single course of rTMS usually needs daily sessions for 4 to 5 weeks. People can also have multiple rTMS sessions in 1 day if they wish, although this depends on factors such as the prescribed treatment, as well as clinic and client availability. There just needs to be a gap of at least 1 hour between the end of an rTMS session and the start of a new session.
There’s also no limit to the number of times you can receive a course of rTMS. Most rTMS treatments will be prescribed in blocks of 20 to 30 sessions, but you can receive multiple blocks, if you want/need to.
Following an initial course of rTMS treatment, clinicians often recommend maintenance sessions. These sessions could be anywhere from once a week to once a month, and help to maintain the positive effects of the rTMS.
You can take a break from rTMS if you wish. However, in order to get the best results, rTMS sessions should happen on consecutive days with as few breaks as possible.
rTMS for depression can be self-funded (meaning you pay for this yourself), or it can be accessed through private medical insurance. rTMS for OCD can be self-funded or accessed through private medical insurance if it co-occurs alongside depression. Please check with your insurer for eligibility.
