Modalities of Supporting Treatment


rTMS is a newer form of therapy for a wide variety of psychological and psychiatric problems. It uses safe technology developed by neuroscientists to deliver pulsing magnetic fields to areas of the brain that are well known to cause mental health issues; rTMS can increase or decrease activity in these areas of the brain. The brain has numerous neurons and other cells, that communicate with each other through electrical and biochemical signals and rTMS can have an effect on this communication.

In 2015 NICE, National Institute of Clinical Excellence, approved the use of rTMS for depression. However, rTMS has been studied in many other conditions and has shown to be helpful in reducing the symptoms of mental health conditions such as Borderline Personality Disorder, Obsessive Compulsive Disorder, Anxiety Disorder and alcohol dependence and dug addictions.

rTMS offers the possibility of treatments without drugs, such as antidepressants, with a minimum relative risk of side effects, for example, when compared to ECT, Electroconvulsive Therapy. It is important to note that rTMS is completely different to ECT and an innovative and unique modality of treatment. Improvements can be seen in some cases as early as 2 weeks.

However, it is important that any person considering this as an option of treatment has a full consultation with a specialist psychiatrist. As in any speciality of medicine, all other stronger evidence-based treatment modalities, should they exist, will be considered and offered before rTMS. The details of this can be discussed with your expert psychiatrist at the consultation. At Elate Health we will do whatever is in your best interest and keep your wellbeing at the centre of our concerns, therefore continuing to provide, ethical, safe and appropriate treatments from leading specialist psychiatrist that you can trust.


ECT (Electroconvulsive Therapy) has had a poor public image for many years. However, for a certain group of patients it is a very effective modality of treatment. ECT treatment uses an electric current through the brain to trigger an epileptic seizure, which can help significantly to relieve the symptoms of a number of mental health problem.

ECT is always performed under a general anaesthetic and the patient is also given muscle relaxants, so that your muscles only twitch slightly, and your body does not convulse during the seizure. It does not involve an epileptic seizure’ as it is generally understood. It is a very controlled medical treatment with protocols and safety measures. A specialist anaesthetist is always present and in control of the anaesthetic and muscle relaxant drugs. Like any medical treatment ECT can cause side effects but these are usually mild. ECT is often effective when other treatments have not resolved the mental health difficulties, for example, in treatment resistant depression, when the full course of treatment is completed, but as any treatment, it may not work for everyone.

Electroconvulsive therapy (ECT) can provide rapid, significant improvements in severe symptoms of several mental health conditions. ECT is used to treat:

  • Severe depression, especially when there is psychosis (a detachment from reality), patients who feel suicidal or refusal to eat.
  • Treatment-resistant depression, a severe depression, that is severely affecting the patients’ relationships and quality of life and has not improved with medications or other treatments.
  • Severe mania, a state of intense euphoria, agitation or hyperactivity that occurs as part of bipolar disorder. Other signs of mania include impaired decision-making, impulsive or risky behaviour, substance abuse, and psychosis.

  • Agitation and aggression in people with dementia, this can be difficult to treat in older adults with conventional medications and may have a severe affect on their quality of life.

ECT may be considered in patients’ when medications have not been tolerated in more than one type usually, or talking therapies have not been effective. It may also be considered during pregnancy, when many medications should not be taken in case of potential harm the developing foetus.

  • In older adults who can’t tolerate drug side effects
  • In people who prefer ECT treatments over taking medications

The number and type of treatments a patient may need depend on the severity of your symptoms and how rapidly they improve.

Most patients can return to normal activities a few hours after the procedure. However, for a smaller group of people it would be advisable only to return to work or work, make important decisions, or drive, which depends on when memory loss and confusion, which can occur in some cases, are resolved.

What kind of results can you expect from ECT?
Many people can feel an improvement in their symptoms after about six treatments with electroconvulsive therapy. It may take longer for full improvement. When compared to antidepressant medications, ECT can improve symptoms quicker, whereas antidepressant medication may take several weeks or more for improvement to occur.
After a course of ECT, medications, or psychological counselling (psychotherapy) may be used to further improve symptoms, if required.


Ketamine is a an old drug, which has recently been researched and used as a new treatment for depression. Ketamine is only used as a treatment for depression, which has not responded to other treatments, e.g. antidepressants. Ketamine may be considered for people currently be suffering from depression, who have tried at least two different types of antidepressants for at least six weeks each at a sufficient and high enough dose that would usually treat depression. Also, it is necessary to have tried some psychological treatment, at least one form of this. Patients must be referred to the clinic by their General Practitioner or Psychiatrist. We have specialist psychiatrist who may be consulted for other treatment modalities, such as Ketamine.

It is important to recognise that ketamine is not licensed as an antidepressant. It has not been evaluated in large, or long term, clinical trials. There is much that is not known about how, or for whom, it works. Large trials of the closely related drug esketamine, which is a component of ketamine, have shown broadly similar effects. A safety study of over 800 patients who took intranasal esketamine and a newly initiated antidepressant showed a 43% remission rate at 12 months. Like all medication side-effects are possible, most of which relatively mild and will stop, more serious side effects can occur, however these are rarer. All of these and any other questions can be discussed with our expert psychiatrists during the consultation.

Contact Us

Birmingham Clinic
6 George Rd,
Birmingham B15 1NP

London Clinic
10 Harley Street,
London, W1G 9PF

Think Well, Feel Well, Live Well

0121 777 2888

Opening Hours

Monday: 10am – 6pm
Tuesday: 10am – 6pm
Wednesday: 10am – 7pm
Thursday: 10am – 8pm
Friday: 10am – 6pm
Saturday: 10am – 2pm