People in Malta suffering from severe depression now have access to an internationally recognised brain simulation therapy that uses electromagnetic pulses.

Psychiatrist Mark Xuereb. Photo: Chris Sant Fournier

This non-invasive therapy – called Repetitive Trans-cranial Magnetic Stimulation or rTMS – is recognised by the US Food and Drug Association as a treatment for patients with major depression, psychiatrist Mark Xuereb told this newspaper.

Dr Xuereb is a member of Crisis Resolution Malta – an association of professionals offering the therapy in Malta. He said term electromagnetic pulses could easily conjure up an image of a mental health patient strapped to a bed with wires stuck to his head.

However, Mr Xuereb stressed, rTMS is “100 per cent non-invasive, natural and painless” and patients can read a book, talk, play with their phone or sit at leisure during a session.

This is the main difference between rTMS and Electroconvulsive Therapy (ECT) – an effective treatment for depression that uses electrical currents to induce a controlled epileptic fit and that has been used in Malta for many years.

In the case of ECT, electrodes are placed on the patient’s scalp and a finely controlled electric current is applied while the patient is under general anaesthesia.

Patients can read a book, talk, play with their phone or sit at leisure during a session

Dr Xuereb explained how rTMS worked with electromagnetic energy that kick-started the part of the brain linked to depression.

A patient is first assessed by a psychiatrist and other staff members who decide whether the person is eligible for this form of therapy that works hand-in-hand with psychological intervention and medication.

“The human brain is an inherently electrical organ that functions through the transmission of tiny electrical signals between nerve cells. There is a particular part on the left side that is the centre for depression, called the left dorso lateral prefrontal cortex. Depressed people have fewer electrical signals in this particular part of the brain. So this new treatment essentially jump-starts that part of the brain,” he said

The machine works by using a probe positioned close to this area of the brain. The probe hovers above the person’s head without making contact.

Each treatment lasts 37.5 minutes during which time the patient is sitting down at leisure – so long as they do not move their head. The patient then leaves and carries on with his daily activities as usual, unlike ECT whereby one needs to recover post-anaesthesia.

A patient would go for treatment every day for up to six weeks and might need top-up sessions periodically. Results may be experienced within days too. The experience is painless and the patient just hears a humming and ticking sound, Dr Xuereb said.

Sometimes a prickly sensation is felt but there are no other known side effects – unlike ECT where patients can experience memory-loss. Pills likewise are well known to have side effects.

A trained team will be providing a comprehensive service to help those many people who suffer daily as a result of this increasingly common illness. At the moment the treatment is only available at a private hospital.

Developed in 1985, rTMS has been studied as a possible therapy for depression. In 2008, the FDA approved it as a treatment for patients with major depression.