Severe or Difficult to Treat Depression


This unfashionable treatment is the gold standard for severe depression and although it has been known to cause memory impairment in some people. It can be lifesaving as it can be more effective than standard treatments. There is some suspicion that the beneficial effects do not last. It is certainly a treatment I would hope my psychiatrist would consider if I was seriously or suicidally depressed. It is possible to arrange it both on an inpatient at the Priory Hospital Roehampton or as an outpatient. ECT is usually given in specialised treatment centres. We use the treatment centre at Springfield Hospital in south London and it is probably the closest clinic. It is an NHS facility which takes private patients. It can be undertaken on an outpatient basis. I also use the Queen Mary’s Hospital Sidcup where there is a new unit recently set up.


This exciting treatment has been shown to be beneficial for some of my patients. I use the clinic in Oxford under Dr Rupert McShane. There is a handout from this clinic available online. Patients would need to monitor their mood using an online tool "True Colours". Patients have three injections of very small amounts of ketamine and there is often immediate improvement in mood. If this is shown to be the case then oral ketamine can be provided via the clinic in Oxford. It is surprisingly inexpensive.

Transcranial Magnetic Stimulation

This treatment is a non-invasive approach which uses strong magnets to alter neurotransmitters systems in the brain. It requires frequent attendance at the clinic in order to have the magnetic sessions.

It is thought to be helpful in the treatment of depression. It is somewhat expensive, given the amount of time that is required over two or three weeks for this treatment. I arrange it either via clinics in London or at the Queen Mary’s Hospital Sidcup.