How it Works 

Our Challenge

People suffer needlessly in silence. They don’t perform at their optimum. They waste their day, plodding through life in a lonely, miserable state when they could be loved, offer love and do so much more. They feel trapped and frozen. They feel they cannot live but simply exist. They are weighed down by life and are convinced that they’re not good enough as they stare at the rest of the world breezing through the day with zest and colour. Sadly, some even contemplate suicide. Their relatives and friends are often also worn, repeatedly trying to assist when they too may bear psychological issues. They become increasingly sad and desperate as nothing seems to help.

Our heart goes out each and every one of them. They are all special in their own way. They deserve to be happy. They deserve to live life to the full because life is beautiful. We at tmsmalta.com want to help them get better. We want them to live and live well! This is the challenge we share with them and their loved ones and we will do our utter best to help you live well.

Our Solution

So what is the solution? To come to a solution we have to remember that in some people various treatments may simply not work. Furthermore, medication may produce intolerable side effects such as weight gain or sexual dysfunction. Nobody wants side effects. Others still, may not wish to take traditional medications or undergo other standard therapies in the first place.

They may yearn for a natural, non-invasive and rapid treatment where you’re awake throughout the procedure and feel better fast to carry on with your life after the treatment. Good professional practice obliges us to listen to these people attentively and to respect their views.

These are all reasons why modern TMS technology was conceived 40 years ago. TMS offers an efficacious and safe solution to all these patients. It can address their concerns and satisfy many of their requests. TMS is the evidence-based solution to maximise recovery through our innovative approach.

Our Approach

Ever since we pioneered the technology locally in 2016 at our TMS Neuromodulation clinic in Birkirkara, Malta, we started to adopt our evidence-based ‘four pillar approach’ or system in various combinations. This consists of 1. Lifestyle changes, 2. Psychological therapy, 3. Medication and 4. TMS. These four individual components, blended together, have a synergistic effect on the person and loved ones. This means that employing these four individual components together produces better results than if they were used individually. Indeed, TMS can boost pre-existing treatments or do away with them altogether depending on the clinical picture.

At tmsmalta.com we are constantly trained and in frequent contact with foreign TMS world experts to employ continuously updated TMS protocols. These protocols target specific areas of the brain involved in the symptoms that are being treated. The benefit of this form of treatment is that it not only reduces the symptoms being treated without virtually any side effect, but often reduces the number of medications being taken to zero, at times.

In conjunction with lifestyle, medication and psychotherapy, TMS can offer fast relief in the symptoms of particular conditions one may have. TMS can also improve symptoms especially in those patients who have had a partial response to medication and/or other therapies.

3 Steps towards a more positive well-being

Step 1

An initial consultation with the TMS clinic staff takes place, using psychology scales. If TMS is good for you, the team will further assess and determine which TMS protocol will work best for you.

Step 2

Once prescribed, the team will explain the procedure, show you around the clinic and book you in for your first TMS session. We will also further explain the efficacy of the ‘4 pillar approach’ to maximise your recovery within the least possible timeframe.

Step 3

The TMS treatment sessions will commence whilst being monitored throughout the experience by our trained clinic staff. Your journey to a more positive state of well-being will start!

This avant-garde, non-invasive treatment aspires to make a difference in the life of those individuals who are miserable as a result of ill health. The length and frequency of this treatment varies depending on the protocol used and on the symptoms and condition being treated. There are virtually no side effects when undergoing TMS and one can return to their daily routine immediately after their session.

During the treatment session the patient remains awake, watches relaxation videos or reads. However, various interventions such as dynamic simultaneous therapy, online mind (cognitive) exercises or symptom improvement tests can be carried out simultaneously during the TMS sessions. For those who want to cut down on their alcohol or drug intake, we show them videos to ‘tease’ the brain into wanting to take the particular drug or alcohol they consume. We then use a special TMS protocol to concurrently dampen the temptation. These and other protocols are designed for you to take full advantage of the TMS experience.

Research has shown that, combined with other therapies, TMS has an enhancing effect so that people feel better sooner. Anecdotal reports from hundreds of our past patients reveal that, thanks to our 4 pillar system, people feel somewhat better within two hours of treatment. Not only. They claim that the quality of their sleep improves and that they wake up in a generally better mood and feel more energetic to face the day ahead. As implied above, for best results, the treatment sessions must be repeated periodically depending on the TMS protocol used and in conjunction with our 4 pillar approach.

Dr. Xuereb and his team aspire to provide top quality, evidence-based TMS protocols which will eventually be used as a first line treatment for all psychological issues, given its natural and virtually side-effect free, rapid mechanism of action.

Frequently Asked Questions

What is TMS?

Transcranial Magnetic Stimulation (TMS) is a revolutionary, painless and localized out-patient clinical treatment whereby a series of repetitive, brief and focused magnetic pulses hit specific brain areas. These magnetic waves serve to facilitate or inhibit brain cell (neuronal) function using natural principles. The person remains alert throughout the procedure which can last from 3 up to several minutes.

What is TMS used for?

As can be seen above, TMS has a growing number of clinical (and research) applications. There is a stash of ever increasing international scientific evidence to provide remedies for both psychological and physical issues. Last year alone, PubMed, an acclaimed online medical search engine, displayed over 2000 TMS research articles (about 40 per week). The most commonly treated disorders include Depression, Anxiety, Obsessive Compulsive Disorder, PTSD, Migraine and memory impairment but TMS is used for many more ailments, sometimes in combination with other standard treatments, resulting in a synergistic effect, as we do at our clinic.

How does our brain work?

To understand how TMS works, we have to understand how a healthy brain works. A healthy brain needs 3 main functioning components to work properly: 1. Conducting wires known as nerves or neurons, 2. Nerve contacts interconnecting neurons known as synapses and 3. Brain chemicals, known as neurotransmitters. All three components must operate well and in unison to maintain good health.

There are about a hundred billion neurons in the adult brain. When a brain performs a task, it releases a combination of miniscule electrical currents and chemicals along parts of its nervous system. Hence the brain is an ‘electrochemical’ organ which neuromodulates (i.e. facilitates or inhibits) nerve function and therefore produces a desired outcome. Neuromodulation allows for neuroplasticity, which is the process by which new neural networks are developed or altered by growing new contacts or trimming contacts between nerves altogether. This is in response to the deluge of information the bran incessantly receives from within the body and the world around us. Neuromodulation and neuroplasticity are thus healthy, dynamic enduring processes which occur as we learn and experience new things in life. 

More specifically, the neurons’ function is to transmit tiny electric currents and chemicals down their entire length. These neurons are interlinked by means of a hundred trillion synapses located at the extremities of neurons. A healthy brain requires a coordinated network of functional nerves (the so called, functional connectivity network), conducting current and chemicals in synchrony, by means of concatenating synapses. These synapses are responsible for most of the intercommunication between nerves located in the brain and in the rest of the body, interconnecting organs with the brain in the process. It is at these synapses that neurotransmitters, produced by neurons, are released into a space between neurons, known as the synaptic cleft.

The released neurotransmitter swims in the synaptic cleft and reaches the head of another adjacent neuron or neurons, known as the cell body. Once the neurotransmitter hits the cell body of a neighboring nerve, it is absorbed into the cell body and a miniscule electric current, known as a wave of depolarization is triggered. This current is propagated down the nerve’s stalk, known as the axon. When the current reaches the end of the axon, neurotransmitters stored there are subsequently released though synapses present there into the distal synaptic cleft. The neurotransmitter then hits another cell body and the process is repeated down the line into various brain structures to perform a brain function. 

This basic, sequential process enables parts of the brain and organs (which are themselves tethered to this neuronal network) to exchange information, integrate it with any past, stored experience and produce a desired outcome.

What happens to the brain when we become ill?

Remember that all three components (wires, contacts and chemicals) are required to work in unison for you to be healthy psychologically and physically as described above. In illness, one or more components become dysfunctional.

Sometimes the chemical may be right but the nerves or synapses may not be. This is one reason why pills or therapy alone just doesn’t work at times.

TMS is ground breaking because it endeavours to treat all 3 brain components in a natural and scientifically-proven way. In other words, when we are unwell, one of more of the abovementioned biological mechanisms may become disturbed due to several factors, depending on the illness.

Neurons may become dysfunctional and shrivel, synapses may break down and fewer or an excess of chemicals are produced. Neuromodulation and neuroplasticity are stunted, crippling brain function. As a consequence, the brain’s functional connectivity network is in disarray.

So how does TMS work?

Growing research shows that TMS revamps the damaged neural network by restoring the neurons, synapses and chemicals through the application of natural physics principles on these brain components.

Harmless pulsating magnetic waves emitted from a TMS coil hit a specific underlying brain area. These waves induce a miniscule electrical current in the neurons. This is accordance with Faraday’s Law of electromagnetic induction. This law basically states that when a changing magnetic field is applied to a conductor (i.e. a neuron in our case) this induces a current in that conductor. Faraday’s Law has had a fundamentally important destiny-changing, planetary role in developing today’s technology and society with its multiple applications. From electricity generators and electric guitars to hard drives and induction cookers, electromagnetic induction has finally found a solid, evidence-based place in treating illness by means of TMS. 

Thus, repetitive volleys of magnetic waves applied to the brain area stimulate the underlying nerves to send the mythical tiny electrical current down the ailing nerve. This reawakens the nerve from its stagnation just like a coach retrains an athlete’s deconditioned muscles. The depolarization down the axon reinvigorates the nerve, healing it in the process. The neuron will then regain its capacity to synthetize synapses and chemicals, ultimately refurbishing the neural network. In essence, ‘Nerves which fire together, wire together’ as the old adage goes. 

Furthermore, stimulation of a particular site propels the whole network to be activated such that even neurons located deep within the brain are facilitated or inhibited with TMS. A number of TMS sessions may be required to achieve this although many people who have undergone TMS experience life changing results very quickly.

What are the benefits of TMS?

  • Scientifically-proven, natural, non-invasive, localised, rapid and harmless treatment.
  • No debilitating side effects (i.e. no weight gain, constipation, dry mouth, heart problems, lethargy, impotence, blurred vision etc.). Only mild scalp discomfort is uncommonly experienced which vanishes quickly.
  • The treatment does not require the patient to receive anaesthesia or chemicals in the bloodstream (i.e. it is non-systemic). The potential side effects of anaesthesia (i.e. confusion, vomiting, memory loss, difficulty passing urine, lung aspiration etc.) are therefore absent.
  • No treatment electrodes are involved as in the case of ECT. The only contact with the scalp is an innocuous, plastic-coated magnet. 
  • TMS is a gentle, outpatient, ‘walk-in-walk-out’ clinic treatment.
  • You remain awake throughout. After the treatment, you just leave the clinic to get on with your day.
  • You can talk, listen to music, relax or engage in dynamic psychological therapy during treatment for maximal benefit.
  • TMS is delivered by qualified staff who monitor you throughout and in between the treatment sessions.
  • The need for pills is reduced to nothing or almost nothing.
  • TMS can be used concurrently with pills and/or psychological therapy or other interventions with synergistic results in keeping with our ‘4 pillar’ approach system.
  • Seeing you frequently, we will remind you to take your medication if you need it. 

Is TMS approved by International Health Organizations?

Yes. In fact, reputable international clinical establishments such as the American Food and Drug Administration (FDA) and the British National Institute for Health and Clinical Excellence (NICE) which set the benchmark for high standards globally, endorse this treatment. Rigorous and independent trials need to take place before such bodies approve any treatment to be safe for public use. Numerous other authoritative bodies based in countries such as Algeria, Australia, Brazil, Canada, India, Israel, New Zealand, Peru and Sweden also validate and commend TMS.

Who can undergo TMS?

Globally TMS has been successfully prescribed to the young and old. It is also safely administered to pregnant and breastfeeding women and those with other serious illnesses including cancer, kidney and liver disease.

‘Medication didn’t work for me’, ‘I developed side effects on other treatment’ or ‘I want a natural treatment’. Is TMS good for me?

Yes TMS can be a good solution in all 3 cases. TMS works for those who have not responded to conventional treatment or for those who developed intolerable side effects on other treatments. In addition, since TMS is based on physics principles and phenomena found naturally in the world around us, it can be described as a natural treatment. In certain cases, for those who do not wish to take any medication or undergo other therapies, TMS can be used successfully as a natural alternative.

I have liver / kidney problems and so my doctor told me I can’t take pills. Is TMS safe for me?

Again, TMS is a good treatment choice for those who have liver or kidney disease or who have had surgery to these organs. It is also ideal for people on dialysis or cancer patients who need minimal medication due to their illnesses. This is because TMS does not enter the blood stream or any other distal part of the body. It only modulates (facilitates or inhibits) the brain nerves directly underneath the magnet.

How long does a TMS treatment session last?

Unlike older, traditional protocols, new protocols are designed to last minutes. Newer protocols are nevertheless equally if not more effective than the first generation protocols, as backed by scientific evidence. Present day protocols last anything between 3 to several minutes at most. You can therefore conveniently slot a TMS session in between your many daily appointments.

How do I know which TMS protocol is good for me?

Don’t worry. Our experienced team is continuously in touch with world centers of excellence and with global TMS experts abroad to design the most appropriate and effective protocol for you in keeping with our pioneering 4 pillar system. Your safety and comfort are paramount to us as our team will assess you and select the most suitable treatment protocol from our ever increasing and exclusive database to get you better as soon as possible. 

Is TMS like Electro Convulsive Therapy (ECT)?

No. TMS is not shock therapy. It works differently from ECT. TMS was conceived to treat psychological problems and symptoms just like ECT but without the side effects ECT has. Whilst having a role in psychological health, ECT bears side effects including confusion, nausea, drowsiness, temporary or permanent memory loss, difficulty concentrating or learning new information, apathy (loss of interest in things) as well as loss of creativity, drive and energy. Besides, ECT requires you to take the day off since you need general anesthesia as though you were undergoing a major operation. You therefore need to be accompanied by a loved one (who also has to be inconvenienced to take the day off) to drive you to hospital and back as you cannot drive soon after anesthesia. Anaesthesia too has side effects including confusion, vomiting, difficulty passing urine and memory loss and can very rarely be fatal. TMS has none of these side effects and is equally appropriate, if not better, in some scenarios.

What are the Possible Side Effects?

TMS is a safe and gentle, well-tolerated treatment with few known side effects. Clinical studies show that the most common side effect is mild scalp discomfort which tends to occur only during the first couple of sessions and resolves spontaneously after a very short time. As technology continues to evolve at a very fast rate, side-effects are becoming virtually nonexistent.

Is TMS dangerous?

No. TMS is safe and not fatal. It won’t fry your brain and smoke won’t come out of your ears! However it is only natural to question new treatments and wonder about side effects. Way back in the 80s when the technology was being developed, scientists were justifiably worried about TMS causing an epileptic fit. Initial concerns of inducing fits dwell within the precincts of initial study reports which are some 40 years old. Treatment protocols at the time were still being refined. The reported fits at the time were all short lived, self-limiting and never caused de novo epilepsy disorder. We have come a long way since, so much so that nowadays, some protocols by default are being designed to prevent and treat preexisting epilepsy. 

What are the absolute contra-indications to TMS?

The Clinical TMS Society (CTMSS) which is the leading, indisputable TMS entity in the world, issued consensus guidelines which state that people containing ferromagnetic material within range of the varying magnetic field (usually some 30cm in radius), cannot undergo TMS. Ferromagnetic material includes shrapnel, some bone plates and cochlear implants. These objects can potentially heat up, move or malfunction, although this is highly unlikely and probably miniscule in magnitude enough to be innocuous. Novel technologies are however being presently looked into to address these caveats and offer the benefits of TMS to these people too.

Will I be taken care of in between TMS sessions? What if I am in crisis?

You will not be left alone in between TMS sessions. In fact, apart from us touching base with you to see how you’re getting on, you can contact us for support. To help you even further, our clinic actively collaborates with Crisis Resolution Malta to follow you up in tandem with us. Crisis Resolution Malta consists of trained, multidisciplinary professionals such as psychologists, psychotherapists, psychiatrists, social workers, spiritual directors and lawyers who are seasoned in crisis management. In essence, you will be offered a truly comprehensive package to fast track you back to a serene and happy life as soon as possible. 

By the way Crisis Resolution Malta also offers a free 24/7, 365 day crisis consultation line run by experienced specialists to ensure you are sustained round the clock if necessary (Tel. +356 9933 9966).

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How did TMS all start?

Ever since man discovered electricity and magnets some 4,000 years ago, his curiosity and creativity motivated him to apply these discoveries to the body to hopefully produce a beneficial effect. Not all went well all the time and there were some glitches in the process. TMS started in similar fashion, developing over several centuries. With the discovery of natural magnets and the subsequent invention of the electromagnet, the search was on to use magnets to heal people by experimentally applying them to parts of the body including the head. 

It was not until the early 80s however, in a British engineering lab in Sheffield, that a PhD student by the name of Anthony Barker who, in collaboration with Reza Jalinous and Ian Freeston, successfully demonstrated that exposing the brain to an inoffensive, varying magnetic field, could produce an observable change in brain activity. Since then, TMS has spread to all continents as a colossal amount of top quality research has taken place to produce the TMS we have today. The good news is that, as research flourishes, the technology keeps evolving, making it more accessible to effectively treat an increasing number of symptoms and conditions for the benefit of mankind.

Is all this too good to be true?

That is exactly what we thought when we were introduced to TMS some 10 years ago! Throughout history, magnetism unfairly gained an onerous reputation due to a lot of sensational promises of cures. These claims were sadly never properly substantiated. These assertions were often based on poor science, magical thinking and were at times peddled by fraudulent and deceptive characters. In the process, the reputation of magnetic therapy was unjustly condemned for centuries. As a result, scientists frowned upon magnets and lost interest in pursuing good research on the efficacy of magnetic treatment in a clinical setting. The Sheffield team’s landmark discovery triggered a renaissance in magnetic therapy research, opening the floodgates to experimentation and a flurry of concrete science was pursued once again.

Today, after painstaking research and worldwide agreement, we have rock-hard proof that TMS really works. Notions that TMS is panacea, pie-in-the-sky or charlatan-speak have long been scientifically dismissed. TMS therapy has now attained the robust clout it duly deserves as a top quality international remedy, recommended by thousands of research papers, great minds and world authorities alike. 

We at tmsmalta.com aspire to continue this legacy to offer excellent quality care. We are honored to be able help people heal, especially those who agonize-often in silence- and cannot achieve their deserved best.

What is transcranial Direct Current Stimulation (tDCS)? Do you offer this treatment?

Transcranial Direct Current Stimulation (tDCS) is a new, non-invasive, painless brain modulation treatment that uses tiny direct electrical currents to stimulate specific parts of the brain by placing 2 electrodes on the scalp. It is increasingly being used for physical and psychological symptoms or disorders. Being portable, this evidence-based marvel can be programmed and prescribed to people to be used in the comfort and privacy of their home and yes, the TMS Clinic does offer this treatment. Feel free to ask our team for details on how to get you better fast.  PUT PIC OF TDCS SOMEWHERE NEARBY.

May I ask more questions?

With pleasure! Please do get in touch via phone, Facebook or email and our friendly, experienced team will be all too happy to answer all your questions, offer advice and provide you with an information leaflet if you wish.

Want to find out more?

Ask a question or book an appointment below.

For emergencies call our free 24/7 crisis consultation line
+356 99 33 99 66

+356 2149 1200

DaVinci Hospital Triq Kanonku Karm Pirotta, Birkirkara, BKR 1111, Malta, Europe

info@tmsmalta.com