Transcranial magnetic stimulation (TMS) for post-traumatic stress disorder (PTSD)

Transcranial magnetic stimulation (TMS) is an innovative, non-invasive method of brain stimulation for the treatment of mental health conditions such as post-traumatic stress disorder (PTSD) and depression.

Here, Dr Aleks George Srbinoski, renowned clinical psychologist based in London, provides an expert insight into how TMS is used for the treatment of PTSD.

What is the recommended treatment approach for PTSD?

The National Institute for Health and Care Excellence (NICE) recommends trauma-focused cognitive behavioural therapy (CBT) for the treatment of PTSD, involving 8 to 12 sessions. As well as this, other therapeutic interventions, such as eye movement desensitisation and reprocessing (EMDR) and exposure therapy, may also prove beneficial.

In terms of medication, Venlafaxine and Risperidone are recommended by NICE. Sertraline and Paroxetine, licensed for use in the UK, can also help relieve some of the symptoms of PTSD.

Currently, 2/3 of patients with PTSD will recover within a six-year period, either suddenly or with treatment. The other 1/3 of patients will unfortunately go on to develop long-term PTSD.

How does TMS work?

TMS works by stimulating the brain through the application of magnetic fields over the scalp. The whole procedure is non-invasive and painless.

During a session of TMS, an electromagnetic coil is placed over the patient’s scalp. The flow of the electric current that passes through the coil produces temporary, high-intensity magnet pulses that permeate the scalp. These magnetic pulses reach the neurons in the targeted cortical area of the brain, changing the level of electrical activity on the brain’s surface. This yields both physiological and behavioural results.

NICE has already approved TMS as a safe and effective treatment option for depression.

How effective is TMS for the treatment of PTSD?

As of last year, five reviews of randomised controlled studies had been published on the use of TMS for the treatment of PTSD.

Recently, a review found that the overall treatment effect size for PTSD was 1.44 with TMS, compared to 1.19 with EMDR and 0.72 with CBT. In another review, it was found that the overall standardised mean difference for the effectiveness of PTSD was -1.13 with TMS, compared to -0.31 with the drug Prazosin which is also used in PTSD treatment.

Notably, in 2018, clinicians observed a significant reduction in symptoms of PTSD in 23 out of 35 patients (66 per cent) who had received treatment for PTSD with TMS.

Overall findings across all treatment studies indicate that TMS is a safe and effective treatment option for PTSD.

What are the treatment outcomes at Smart TMS?

At Smart TMS, 9 out of 10 patients (92 per cent) who had received treatment for PTSD with TMS experienced a minimum of 20 per cent improvement in their symptoms. In another case series, 6 out of 12 patients (50 per cent) who had received treatment with TMS no longer met the diagnostic criteria for clinical PTSD after going into remission (a disappearance of symptoms).

Current scientific evidence supports the effectiveness of TMS as a treatment option for PTSD, even more than with CBT and EMDR. Patients living with persistent symptoms of PTSD are recommended to consider TMS as a possible treatment option.

Dr Aleks George Srbinoski is a leading clinical psychologist with over 15 years’ experience.

If you are living with symptoms of PTSD, don’t hesitate to reach out to Dr Srbinoski via his Top Doctors profile today to receive expert treatment and management.