From Cigarettes To Cocaine: The New Treatment For Addiction
What exactly is TMS?
Repetitive Transcranial Magnetic Stimulation – also known as TMS – uses pulsing magnetic fields to activate or suppress the brain centres associated with a number of medical and psychiatric disorders. Unlike ECT (electroconvulsive therapy), which treats the whole brain, the TMS magnetic coil is only applied to the area of the brain shown by scans to be most associated with the condition being treated. It also only reaches about two to three centimetres into the brain, directly beneath the treatment coil.
As these magnetic fields pulse, they produce very small electrical currents which increase or decrease activity in the brain centres associated with the condition. Each session lasts between 15 and 40 minutes, with a minimum of ten daily sessions recommended.
Is it safe?
The magnetic fields used in TMS are the same type and strength as those produced by magnetic resonance imaging (MRI). Since being invented at Southampton University in the 1980s, it’s been the subject of active medical research – it was FDA approved in America for treating depression in 2008, and approved for use in Europe in 2015.
What does it treat?
TMS has been approved by the National Institute for Health and Care Excellence (NICE) as an effective and safe treatment in the UK for the treatment of depression. It has also been shown in research studies to be effective in reducing the symptoms of: anorexia, chronic neuropathic pain, drug addiction, depersonalisation disorder, fibromyalgia, obsessive compulsive disorder and PTSD.
TMS treatment should be considered when all evidence-based treatments have already been attempted under specialist supervision.
Who is it suitable for?
Prospective patients must be screened before treatment to assess their suitability, including speaking to a psychiatrist about their condition. It’s not suitable for under 18s, people with a history of seizures or anyone with a metal implant in their brain.
Talk us through a typical treatment…
SL hasn’t tried the treatment, but have seen it in action at London’s Smart TMS Clinic. We accompanied a patient who had been smoking for 25 years, and wanted to quit – they’d tried before, but with little success.
Firstly, she was assessed by clinical psychologist Aleks Srbinoski, who explained which part of her brain would be treated. “The frontal lobe is the sector associated with decision making and impulse control,” he told us. “Stimulating that area, thus making more dopamine, allows the patient to feel better and have more ability to refrain from behaviours they would later regret.”
The treatment itself was far less scary than it sounded. The patient sat comfortably on a bed, and a Smart TMS technician placed a thin white cap over her head. Once the machine was set to the right frequency and the coil positioned correctly above the cap, it was turned on – making a clicking sound as it worked in short bursts. “It’s not painful, but slightly uncomfortable,” the patient told us, describing the sensation as “like when you’re about to get an ice cream headache”.
“Even with the first treatment, TMS dissipated all my urges to smoke,” the patient told us after her third session. “It also eliminated all the nervousness and anxiety you get when quitting smoking – you’re irritable, you’re cranky – I don't feel any of that.” Two weeks on from her tenth and final session she had seen a marked improvement, going down from 20 to two cigarettes a day. “The big problem is the habit,” she said. “You have to really work at that. Boredom is still a big problem for me sometimes.”
What are experts saying?
Dr Cosmo Duff Gordon, founder of Start2Stop, a specialist private clinic for addiction problems, told SL he can see TMS becoming a key element in the addictions treatment armoury, and that it could have a place in rehab clinics one day.
“TMS seems to be strongly evidence-based as effective in treating severe depression where conventional psychopharmacological treatments haven’t worked, and many people with addictive disorders struggle with co-occuring depression,” he said. “Research at my clinic, Start2Stop, suggests many such people will likely find their depression clears up as they get into long-term recovery and their brain chemistry, as well as lives, get back on track. But there are also many people who are able to get into long-term recovery and yet remain very depressed – and this can often be a key factor in relapse.”
For more information, visit SmartTMS.co.uk
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