Neuromodulation clinic

Our Neuromodulation Clinic currently offers two medical treatments: electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). Both of these treatments are given at Meadowfield Hospital in Worthing.

Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is a safe, effective, evidence-based medical treatment. It is sometimes recommended for people with one of a number of diseases, most commonly depressive illness.

Your doctor may discuss ECT with you, especially if other treatments have not helped or if your life is at risk.

ECT might be the right treatment choice for you if you are experiencing:

  • depressive illness – particularly if this is severe or not responding to other treatments
  • manic illness – a state of elevated energy and mood
  • schizophrenia – when symptoms are not improving on other treatments
  • catatonia – a syndrome of abnormal movements or behaviours, which can be life-threatening 

In depressive illness, ECT works more rapidly, and is more likely to be effective, than other treatments.

Our ECT service is for inpatients and outpatients in West Sussex and Brighton and Hove. 

Patients are referred for ECT by their psychiatrist. 

During ECT, the patient is put to sleep using a general anaesthetic, and an electrical stimulus is applied to the top of the head or temples. This triggers a short seizure (or 'fit'), which helps to relieve the symptoms of the illness. The treatment is usually given twice weekly, over 4-6 weeks.

Our ECT team includes a specialist psychiatric doctor, an anaesthetic doctor, specialist nurses and operating department practitioners. The patient's physical health is fully monitored throughout the procedure and afterwards. As well as a general anaesthetic, patients are also given a muscle relaxant, to minimise body movements during the seizure.

Before a patient is referred to the ECT clinic, their psychiatrist will explain what the procedure involves, along with the benefits, risks and possible side effects. Patients are given the opportunity to ask any questions they might have. They should then be able to make an informed choice about their treatment.

If a patient is able to decide to go ahead with ECT, they are asked to give written consent to treatment. Consent can be withdrawn by the patient at any time.

We follow the guidance given by the National Institute for Health and Care Excellence (NICE).

We also strictly adhere to quality standards set out by the Royal College of Psychiatrists which you can read here. 

Repetitive Transcranial Magnetic Stimulation

Repetitive transcranial magnetic stimulation (rTMS) is a safe, effective, evidence-based medical treatment. It is sometimes offered to people with depressive illness or obsessive-compulsive disorder (OCD).

Your doctor may discuss rTMS with you if you have depressive illness or OCD and other treatments have not helped.

Although rTMS can often work in depressive illness when medication has not, it is not quite as effective as electroconvulsive therapy (ECT).

Although rTMS can often work in OCD when medication and psychotherapy have not, it may not be quite as effective as other specific treatments.

The rTMS service is for inpatients and outpatients across the whole of Sussex (including West Sussex, East Sussex, Brighton and Hove).

Patients should have an established diagnosis of depressive illness or obsessive-compulsive disorder (OCD).

Patients are referred to our service by their psychiatrist. Sometimes a referral does not progress to an assessment in the service. This might happen if it is apparent that the patient does not have one of the types of mental illness that can be helped by rTMS.

If a referral has been accepted, the patient is then fully assessed in clinic by our specialist psychiatrist. This assessment focuses on the symptoms of illness, to establish whether there is an illness that can be treated with rTMS. Attending an assessment does not mean that the patient will automatically be offered the treatment.

If it is confirmed that the patient has an illness that can be treated with rTMS, the psychiatrist explains what the procedure involves, along with the benefits, risks and possible side effects. Patients are given the opportunity to ask any questions they might have. They will then be able to make an informed choice about the treatment.

If a patient decides to go ahead with rTMS, they are asked to give written consent to treatment. Treatments are then given five times a week, usually over a month or more. Consent can be withdrawn by the patient at any time.

In each treatment session, during which patients remain fully conscious, an electromagnetic coil is placed over the scalp to stimulate specific areas of the brain. Each treatment lasts between three and 18 minutes, during which patients are supported continuously by our specialist nursing team.

Visiting the service

If you have been referred for ECT, you can be shown around the clinic on the day of your first planned treatment. If you have been referred for rTMS, you can be shown around the clinic on the day of your assessment appointment. This includes viewing the treatment equipment.