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Torsa

Cure my OCD

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Thanks for sharing Torsa :)

Wow I'm shocked that the BBC have put this up. The source for the evidence for TMS was an individual?! I think that says it all really. Unfortunately though, the stats this person says seem really encouraging compared to the inconclusive results from NICE. I really thinks this leads vulnerable people to get treatment like this. 

The treatment is £200 and someone with OCD might need up to 30 sessions. 

I feel for the man suffering with OCD but he needs specialist CBT, not TMS. He is clearly doing lots of compulsions so no wonder his life is so difficult. I just hope that someone makes him aware of just how good CBT can be. 

Also, was that Prof. David Veale, they had him called David Healy? 

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I feel for Conor, and if he does go down this route I hope it helps, but I hope he does not give up on traditional therapies. The film listed his treatment, but I wonder how much quality therapy he's received up to now. His understanding of how medication is meant to help was perhaps not quite right, possibly?

Like you Torsa I am sceptical about the evidence for TMS,  for one reason. In 2017 and early 2018 I read numerous newspaper articles about this miracle OCD treatment (TMS),  but all those articles read more like an advert. They all were able to same chap who was suffering and all promoted a company called Smart TMS.

This film also promotes Smart TMS.

I would love to know where the idea for this film came from, did Connor approach the BBC or did Smart TMS instigate it (call me cynical). 

The timing is interesting too, someone is trying to push TMS through the NICE onto the OCD guidelines, despite the limited evidence.  Someone, a Dr claims there is increasing evidence and patient demand, but NICE can't tell me who said that or where such demand is.  So I am sceptical about whose is actually trying to push TMS through NICE and I wonder if they have any links to SMART TMS.

The film states (taken from the NICE consultation we promoted a few months ago).

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A 2019 report into the NICE guidelines towards treatment of OCD siad current evidence about the effectiveness of TMS to treat OCD was inconclusive, due to mixed findings.

No this part makes sense from what I hear and have read.  So with such limited understanding I am at a lost to understand why NICE are looking at this.  The film then states.

Quote

But experts the organisation has spoken to say there is merging evidence supporting the use of neurostimulation.

I queried this with NICE who and what evidence, they couldn't or wouldn't tell me. 

 

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That's terrible. So if the BBC were approached by Smart TMS and now it's on the BBC there could indeed be an increase in 'demand' because of it. It seems hugely irresponsible of the BBC.

I'm not skeptical, I completely disagree with treatments like this. 

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That's interesting - I didn't know the full backstory around Smart TMS. The treatment makes little sense to me... OCD is such a complex and embedded thing, and I really can't see how zapping the brain with magnetic fields would have any benefit, apart from maybe via the placebo effect. I really hope he's able to get the help he needs... which I agree is probably some good quality, intensive CBT.

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2 hours ago, Gemma7 said:

So if the BBC were approached by Smart TMS

 

1 hour ago, Torsa said:

I didn't know the full backstory around Smart TMS.

 

Just to be clear guys, the above is just my theory rather than known fact. I may be putting 2 and 2 together and getting 5.  Certainly all the adverts in papers like the Mail and other local and national papers about 18 months ago on the fact of it read like an interesting article / story. But to me, because each article feature the same patient and references to Smart TMS I just wonder if they were actually adverts masquerading as articles. But I can not prove that.

2 hours ago, Gemma7 said:

now it's on the BBC there could indeed be an increase in 'demand' because of it.

Now this is the part where if someone was really, really cynical you could start to become suspicious.  In January NICE consulted on the existing OCD guidelines. Prior to opening up the consultation they consulted 14 topic experts and received 4 responses.  So 4 'topic experts' replied.  But when I asked who these people were, to gauge any conflict of interest NICE refused to divulge.

Topic experts completed a questionnaire about developments in evidence, policy and services related to the OCD NICE guideline.  NICE then published this on the consultation…

Quote

topic experts indicated that there is consistent emerging evidence supporting the use of neurostimulation and rising demand from the patients for the intervention.

So, one or more of just four so called topic experts claimed there was an increase in demand, which as led to NICE reviewing TMS for OCD now.   Now thankfully, the evidence will be consulted before anything is recommended.

But as a charity I generally get to see a trend in what patients want on emails, phone calls, social media. I did receive one or two emails about TMS after the Daily Mail article. 

Nov 2017 - https://www.dailymail.co.uk/health/article-5063279/Man-OCD-cured-transcranial-magnetic-stimulation.html

Jan 2018 - https://www.express.co.uk/life-style/health/902151/OCD-cure-magnetic-therapy-transcranial-magnetic-stimulation

but I am not sure those one or two emails is indicative of 'increased demand' and beyond that I am not getting requests about TMS. I am not seeing anything much on social media about it either.   

Which brings us back to your point Gemma and my cynical side. If a commercial TMS company are behind the 'articles', i.e. creating press releases they pass over to the media to 'generate' a story they could be trying to inflate 'demand for TMS'.  Which brings us back to those topic experts, I would really like to know who they are to review if there are any conflicts of interests with a commercial TMS company.

Another Daily Mail article about a woman with depression who had TMS... with Smart TMS again, the article stated NICE approved for depression in 2015, it then said... 

Quote

Dr Leigh Neal, a former NHS consultant in psychiatry and medical director of Smart TMS clinics, told the Daily Mail how treatment works:

So there's certainly medical knowledge of NICE within Smart TMS.  Who is to say that the NICE topic experts doesn't include representatives of a commercial TMS company. If not this guy or company, some other Dr at another company. 

Of course I may be wrong, this may all be coincidence, the topic experts may be independent and there may be a general rise in demand for TMS.  Maybe I am just old and cynical these days?

 

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I don't think what you're saying is particularly cynical, it seems like a very plausible explanation. It was interesting in your email, where they said there was no specific area of the brain that causes OCD, but they target specific cortical areas. Confusing. 

They also said it is hypothesised that. Oh my, its merely a hypothesis, they can't actually prove it. It seems very like the backwards engineering that lead to SSRIs. They might notice an improvement and then they try to explain it with 'science' :headslap:

What I don't understand is this. If you have a maintained improvement due to targeting a non specific area, then how come it affects no other connections other than the ones causing OCD. If it has no side effects, is it actually having any affect? 

Their website also has no evidence on it for TMS for OCD that I can see and very much seems like a money making enterprise. 

I imagine that the reason there hasn't been a demand is because you Ashley won't be where people will go. They sort of know what a national charity are going to say about such an alternative therapy. That doesn't mean there is an increased demand, more that these adverts target the people who will contact them, and it's then that they can claim an increase in demand. 

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15 hours ago, Closed for repairs said:

So how do those costs compare to say 10 sessions of  face to face CBT, (to the NHS)?

I doubt that's been worked out yet. But I'm willing to bet it would be cheaper. Paying for a qualified CBT therapist to give an hours therapy is bound to be more expensive then someone working one of those machines, which will probably be done by a nurse and probably done faster, potentially seeing multiple people at once. 

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1 hour ago, Gemma7 said:

I imagine that the reason there hasn't been a demand is because you Ashley won't be where people will go. They sort of know what a national charity are going to say about such an alternative therapy. That doesn't mean there is an increased demand, more that these adverts target the people who will contact them, and it's then that they can claim an increase in demand. 

Oh absolutely, I don't for one minute believe we are the only barometer of 'demand', but generally I do see a trend through various sources.... my own services, social media, local health professionals often turn to us for advice too. I just don't see it with TMS (or DBS).  I see a few but not a trend.  The only people seemingly pushing TBS and a very different procedure, DBS are the health professionals with interests in researching/treating it.

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Could you make a freedom of information request from NICE, to ask them to disclose who the experts were? 

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On slightly different note,

This is the sort of narrative the TV likes, dramatic problem,   

"  he thinks he has run some one over and it's ruining his life!"

Magic bullet solutions

" Our new process may cure him"

All neatly tied up and over to Sally with the sport.

To be fair I thought they handled the OCD bit quiet well but would have been more interested in how CBT did or didn't help, what were the NHS resources like in his area, etc.

 

 

 

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2 hours ago, Ashley said:

Another plug for TMS and Smart TMS in the Daily Mail, based on the BBC film.

https://www.dailymail.co.uk/femail/article-7461443/Man-27-suffers-OCD-thinks-hes-killed-films-moment.html

Also today, Smart TMS emailed me asking if I had seen the film... their PR people are good, will give them that. 

I have just been reading through the comments from others on that link, and I am amazed at how many refer to OCD as a disease, as opposed to disorder?

There were 718 that liked a comment about this, with 8 disagreeing, but when someone replied pointing out that it a mental condition, this was rated as 7, with about 10 dislikes?

 

 

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That's interesting Felix, sounds suspicious doesn't it. I'll have to check other Daily Mail article tomorrow.

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4 hours ago, felix4 said:

I am amazed at how many refer to OCD as a disease, as opposed to disorder?

There were quite a few comments wasn't there.  I am not sure the general public know what OCD really is, but I am not sure people would consider it a disease either.  3 from 53 commentes refer to it as a disease.  The one you refer to Felix is unusual number of likes.  Most others at that time got less than a dozen. I was surprise to see some of the others getting 100-200 likes. Unusual for an article about OCD?

DM.jpg

Perhaps a coincidence the language used in the comments, but the BBC film was poorly put together, and now a Daily Mail article from it.   I read in Smart TMS email to me they recommend patients have a course of 10 sessions, costing £2500.   Big money, so you can understand why promoting TMS is worth it if you have a lot invested....  and yes I am cynical :D

 

 

 

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One of the authors of one of the research articles on the TMS thread was a founder of TMS clinics Australia and that comment was from Australia. 

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