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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by delna on November 17, 2009, at 8:37:38
Does anyone know if TMS is being practiced in the UK. I've been looking on google and I can't seem to find any institutes that actually offer it.
Is it something that is used commonly in the UK, yet?
I know its not here in India yet....
I am planning on going back to London and be in hospital for a bit. My pdoc has replied to my email and asked for an update (been 8 years since I saw her). I just hope TMS is an option in London. Perhaps not at the hospital itself but somewhere..
Does anyone know?
The US is ridiculously expensive if you are uninsured :(
Thanks
D
Posted by Katgirl on November 17, 2009, at 11:19:30
In reply to TMS in the UK?, posted by delna on November 17, 2009, at 8:37:38
OOPs, I guess I should have posted here instead of on the other thread. I don't know about the UK, but I paid out of pocket for it in Canada (I'm from the U.S.) Also, there is apparently a doctor in Atlanta who does rTMS on a sliding fee scale. Where are you currently living?
Posted by delna on November 17, 2009, at 11:28:06
In reply to Re: TMS in the UK?, posted by Katgirl on November 17, 2009, at 11:19:30
> OOPs, I guess I should have posted here instead of on the other thread. I don't know about the UK, but I paid out of pocket for it in Canada (I'm from the U.S.) Also, there is apparently a doctor in Atlanta who does rTMS on a sliding fee scale. Where are you currently living?
India..but I'm from the UK
Can i ask how much u paid?
Posted by Phillipa on November 17, 2009, at 12:03:16
In reply to Re: TMS in the UK? » Katgirl, posted by delna on November 17, 2009, at 11:28:06
That doc is well known here and controversial let me see if can find his name. Love Phillipa
Posted by Katgirl on November 17, 2009, at 12:05:43
In reply to Re: TMS in the UK? » delna, posted by Phillipa on November 17, 2009, at 12:03:16
I believe it was around $6000. I really was about to die, so for me it was worth the risk financially. I went to the Mindcare Centre. I went to the one in Toronto because it was drivable from Wisconsin, but they have one in Vancouver as well.
Posted by Meltingpot on November 17, 2009, at 12:26:55
In reply to TMS in the UK?, posted by delna on November 17, 2009, at 8:37:38
Hi Delna,
I know that about 5 years ago they were doing trials of rTMS at The Maudsley Clinic in London, I think a "Dr Declan Mclaughlin" was running the trials, I spoke to him about the trial on the phone.
It might be worth you contacting the "Maudsley Clinic" to see if they are still doing trials or know of any hospitals that are using it.
I hope you get some help soon. I'm in the same boat as you as far as ECT goes (although I don't know if you want it) I keep asking for it and I keep being told I'm not a good candidate for it.
I think that in order to be a candidate for ECT your depression has to be that severe that you are in an almost vegetative state.
Denise
Posted by Phillipa on November 17, 2009, at 12:40:09
In reply to Re: TMS in the UK?, posted by Meltingpot on November 17, 2009, at 12:26:55
Delna couldn't find the doc and Denise so glad you saw this. Love Phillipa
Posted by delna on November 17, 2009, at 13:04:43
In reply to Re: TMS in the UK?, posted by Meltingpot on November 17, 2009, at 12:26:55
> Hi Delna,
>
> I know that about 5 years ago they were doing trials of rTMS at The Maudsley Clinic in London, I think a "Dr Declan Mclaughlin" was running the trials, I spoke to him about the trial on the phone.
>
> It might be worth you contacting the "Maudsley Clinic" to see if they are still doing trials or know of any hospitals that are using it.
>
> I hope you get some help soon. I'm in the same boat as you as far as ECT goes (although I don't know if you want it) I keep asking for it and I keep being told I'm not a good candidate for it.
>
> I think that in order to be a candidate for ECT your depression has to be that severe that you are in an almost vegetative state.
>
>
> DeniseHi Denise,
I am in a vegetative state!!! I haven't gotten out of bed for 2-3 months- except to see a doctor or check out my su***de location.
Thanks for the tip on the Maudsley clinic. I will get in touch with them.
But once I am in hospital, I fear it will be up to my pdoc if I have TMS. And since the hospital i am going to does not do TMS (they just emailed me) I don't think she will send me out for it. But they do have ECT.
I'd be happy to have ECT except that anesthetic itself gives me depression (or maybe they use something special since so many people get depressed post-anesthesia)Maybe I need to go to a more research based hospital.... This is my usual http://www.nightingalehospital.co.uk/
Don't let the fact that they make it look like a hotel fool you ;-)
Thanks again
Hope you are doing better..
Love
D
Posted by maxime on November 17, 2009, at 13:21:59
In reply to Re: TMS in the UK? » Meltingpot, posted by delna on November 17, 2009, at 13:04:43
Which hospital are you going to? Is it in England?I would imagine that you would be a great candidate for ECT even though you have been told otherwise. I wish you the best of luck!
Posted by delna on November 17, 2009, at 13:29:52
In reply to Re: TMS in the UK? » delna, posted by maxime on November 17, 2009, at 13:21:59
> Which hospital are you going to? Is it in England?I would imagine that you would be a great candidate for ECT even though you have been told otherwise. I wish you the best of luck!
Probably one in London.
So far I have only a few prices from US hospitals and it comes to around 2500 ++ USD per day, as an inpatient which is expensive. Though really the US is the right place to be if you have a psychiatric problem.
Thanks Maxime
D
Posted by SLS on November 17, 2009, at 16:03:23
In reply to Re: TMS in the UK?, posted by Meltingpot on November 17, 2009, at 12:26:55
> I hope you get some help soon. I'm in the same boat as you as far as ECT goes (although I don't know if you want it) I keep asking for it and I keep being told I'm not a good candidate for it.
You probably are not a good candidate.
I think the ideal candidate for ECT is someone who has not shown resistance to pharmacotherapy, but whom is melancholic and suicidal or immobilized by psychomotor retardation.
Of course, it might make sense to go with ECT if nothing else works. I tried ECT 18 years ago. Nothing. Of course, you might find ECT to be a great treatment, with the understanding that you will most likely need to go for regular maintenance treatments.
Can you think of any drug treatments that you have not yet tried? If so, you might want to wait a little longer before going with ECT. I would sooner try rTMS if it is available.
- Scott
Posted by SLS on November 17, 2009, at 16:06:23
In reply to Re: TMS in the UK? » Meltingpot, posted by delna on November 17, 2009, at 13:04:43
> I am in a vegetative state!!! I haven't gotten out of bed for 2-3 months- except to see a doctor or check out my su***de location.
That sucks.
Sorry...
I hope you find something fast.
- Scott
Posted by Phillipa on November 17, 2009, at 19:31:01
In reply to Re: TMS in the UK? » Meltingpot, posted by delna on November 17, 2009, at 13:04:43
Delna personally I've never seen a more grand hospital that this one. How's the care? Love Phillipa
Posted by meltingpot on November 18, 2009, at 8:37:49
In reply to Re: TMS in the UK? » Meltingpot, posted by SLS on November 17, 2009, at 16:03:23
Hi Scott,
I tried rTMS at a centre in Vancouver. Ironically that was back in 2004 when I was feeling a lot better and the Seroxat was working. I tried it because I wanted to see if it would help and if it did so then it would always be something to fall back on.
Unfortunately, it did nothing for me, he might as well have been tapping my head with a small hammer.
That's not to say it doesn't work for everyone, I know somebody in the States who suffers from a more atypical type of depression and he says it really helps his energy levels.
I know that ECT is considered more for people with vegetative symptoms and people who have psychomotor retardation. I do have suicidal fantasies every day. I can see myself 5 to 10 years down the line still searching in vain for something to lift me out of this dysthymic state and finding nothing.
I think that I just want to try ECT because I haven't tried it properly (as mad as that might sound).
Denise
Denise
Posted by meltingpot on November 18, 2009, at 8:44:45
In reply to Re: TMS in the UK? » Meltingpot, posted by delna on November 17, 2009, at 13:04:43
Hi Delna,
Like you say maybe you should ask to go to a research centre that does do rTMS. I think it would be worth ringing the Maudsley just to find out where rTMS is practiced and then maybe you can think about having it in the future, even if you don't have it now. Having said that I know that when you feel desperate you want to try something now! Not some time in the distant future.
Sounds like you are a better candidate for ECT than I am if you haven't been out of bed for months.
Anyway, you sound like you still have a lot of fight left in you. I hope you find something to help soon.
Keep us updated.
Denise
Posted by Katgirl on November 18, 2009, at 8:59:21
In reply to Re: TMS in the UK? To Delna, posted by meltingpot on November 18, 2009, at 8:44:45
Hi Denise-
Its amazing how we all react as differently to rTMS as to medications. Within three days I knew I was definitely receiving a treatment that was affecting my brain because I felt like I was going to crawl out of my skin from the worst anxiety imaginable. I was at the newer (at the time) Toronto site and they called Vancouver to see what the hell was happening to me. Turns out, I was having what they called "the Prozac" affect. They had seen it before and they said that most people who had that cluster of "side effects" (is there NOTHING I don't have bad side effects to???) also were responders to the therapy. Basically I had a bad reaction to the rTMs in a very similar way I was having bad reactions to the medication. It was just a bit too much for my system! Anyway, they were correct in that I did end up being a "responder". I just had to get worse before I got better.
Posted by SLS on November 18, 2009, at 12:15:34
In reply to Re: TMS in the UK - To SLS, posted by meltingpot on November 18, 2009, at 8:37:49
Hi Denise.
I didn't know that persistent dysthymia was how you experience depression. It sounds like you suffer from double depression - chronic dysthymia punctuated by episodes of major depression. It is not surprising that you are having so much trouble finding treatments that bring you to total remission. Double depression and dysthymia are difficult to treat. It the UK, I believe you have sulpiride and amisulpride available. Low dosages of these drugs are supposed to be helpful for treating dysthymia. Maybe you could combine one of these drugs with pramipexole or ropinerole, understanding that you will probably need a traditional antidepressant to treat a major depressive episode should one develop. For you, I would advise reducing your stress level as much as you can and avoid systemic infections if possible.
Have you ever combined:
bupropion
venlafaxine or escitalopram
lamotrigine
lithium
thyroid hormone
- Scott
Posted by SLS on November 18, 2009, at 12:39:11
In reply to Re: TMS in the UK - To SLS » meltingpot, posted by SLS on November 18, 2009, at 12:15:34
I almost forgot. Of the two drugs, sulpiride and amisulpride, I would choose amisulpride to treat dysthymic disorder. Unlike sulpiride, amisulpride is an antagonist of 5-HT7a receptors. This property is now the focus of investigation as to how the drug produces its antidepressant effect.
- Scott
Posted by Meltingpot on November 19, 2009, at 10:49:10
In reply to Re: TMS in the UK - To SLS » meltingpot, posted by SLS on November 18, 2009, at 12:15:34
Hi Scott,
I'm not sure how I experience depression anymore either. When this all started again back in 2001 I was noticing that I was very irritable all of the time and when I wasn't irritable I felt totally flat and uninterested in anything. It was only when I took a holiday (thinking that might help) that I got worst. All I could do on that holiday was pace and walk and walk and just keep walking and smoking. I had no enthusiasm for anything.
I've been on so many medications since then and I think now I'm reacting differently to the medications than when I first started. I find that when I come off everything I feel listless lifeless (especially when I'm not working). I have not motivation, no interest and I start to feel very anxfrious because of that. This week has got progressively worst. I went for a walk with my mum and whilst she chatted away I felt pretty much unresponsive, not really moved by anything at all. I tried cleaning a friends house yesterday but was just very snappy and irritable and wondering why I was bothering. I tried chatting to a friend but just wanted to get away from her and from everything and I was feeling more and more suicidal.
I took a Zyprexa yesterday and am feeling a tad better today but I'm still having suicidal thoughts, not sure if I could do it or not though.
I am still able to work (with the help of the Zyprexa) now and again but have very little inclination to do anything else really.
To answer your question, I tried Effexor back in 2001, I think I got up to about 150mg and noticed a slight improvement sometimes but was still having suicidal thoughts and a lot of anxiety.
I also tried lithium back in 2001 although not sure what dose (and that didn't seem to help at all)
I also tried lamictal back in 2002 for three months and that didn't seem to do anything. I also tried it along with an SSRI (prozac I think).
Finally in 2003 high dose seroxat seemed to do the trick (after 4 days). It's strange really though because whilst it was working I suddenly wanted to do things I hadn't wanted to do before (even before I became depressed again). I started learning to play the piano, I started going out late, smoking weed (only occassionally), being very flirtatious and just generally enjoying myself. Although I was never a party animal or anything (but I never have been a party animal and don't particularly want to be)
Then when Seroxat stopped working, I noticed the lack of interest came back, I stopped wanting to go out socially and then when I did go out I just wanted to get back home again, the anxiety came back etc. I had been walking a neighbours dog and whilst I was well I felt affection for the dog but then when the Seroxat stopped working it just seemed to be something on the end of a lead. Although I wasn't as bad as I had been prior to taking the Seroxat.I tried increasing the Seroxat to 60mg to no avail and my psychiatrist tried adding (in this order) buspar, lamictal and thyroid hormone for a month a time and I still felt no improvement. I think he added mirtazapine for a while and still no real improvement. When I say improvement I mean that "wanting to do things" had gone.
I came off Seroxat completely later on and just felt pretty much as I do now, lifeless really and then I was put on Lexapro and was okish for about a year of so until it stopped working and I became extremely anxious and sucidal. Now my suicidal thoughts might be different to other peoples in that I never actually act on them, mainly because the Zyprexa seems to help to give me a breather from the really bad feelings. If I didn't have the Zyprexa then I could see myself acting on the thoughts but I'm still not sure.
So you might now see why the NHS psychiatrists have stopped trying.
The only thing I can think of that I haven't tried is ECT and I'm told I'm not a good candidate, so it's back to sucidal thoughts again because I can't think of anything else.
I'm not bad enough to warrant ECT but I'm bad enough to feel like I just want to die.
I can funtion but I don't really feel like I'm living. If I leave it longer than a week before taking the Zyprexa then I just feel like I really can't go on anymore. I'm going to try just taking a small amount of Zyprexa every night but I think I tried that and I still felt uninterested in things but without the apathy and listlessness.
If I suffer from double depression then I'm not sure how this can be because whenever I come off medication the feelings are always the same, they never seem to be any worse or any better. When I go back on medication then after a while I'm better but not fully better and I just continue like that so I'm not having any "episodes" as such.
I know this is probably a lot more than you wanted or needed to know :-) If you are not up to reading the whole lot then I can just sum it up in a seperate post by listing the meds I've tried and my reactions to them.
Denise
Posted by delna on November 19, 2009, at 13:49:12
In reply to Re: TMS in the UK? To Delna, posted by meltingpot on November 18, 2009, at 8:44:45
> Hi Delna,
>
> Like you say maybe you should ask to go to a research centre that does do rTMS. I think it would be worth ringing the Maudsley just to find out where rTMS is practiced and then maybe you can think about having it in the future, even if you don't have it now. Having said that I know that when you feel desperate you want to try something now! Not some time in the distant future.
>
> Sounds like you are a better candidate for ECT than I am if you haven't been out of bed for months.
>
> Anyway, you sound like you still have a lot of fight left in you. I hope you find something to help soon.
>
> Keep us updated.
>
>
> DeniseMy pdoc from London replied to me. She said TMS is not available at the hospital but she would look out for a place I can go to. She also added that it hasn't shown good results for resistant depression.
Love D
Posted by Meltingpot on November 23, 2009, at 5:03:04
In reply to Re: TMS in the UK? To Delna » meltingpot, posted by delna on November 19, 2009, at 13:49:12
Hi Delna,
Maybe it hasn't shown really good results for TRD but I do know of somebody in the States who was in a pretty bad way, I think his symptoms were more atypical (as in sleeping all of the time). I think he was pretty resistant to medication but he found ECT and then later on rTMS really helpful.
It's got to be worth a try. Why don't they think you are a good candidate for ECT?
What type of depression do you suffer from?
Denise
This is the end of the thread.
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