rTMS for Depression: Precision Care at the Neurological Root in London
Depression has a neurological signature. The pathways driving it can be restored.
precision rTMS for depression in london
At Naya Health, we use precision rTMS to restore and regulate the neural circuits underlying depression.
Gentle, targeted magnetic pulses work directly at the neurological level, addressing the pathways driving low mood, fatigue and cognitive slowing at their source.
NICE-approved, drug-free, and guided by objective measurement throughout.
For those who have carried depression for longer than they should have had to, Naya offers something different: precision care at the neurological root.
we are a Precision rTMS clinic in London
How we can treat Depression, including Treatment-Resistant Depression
Naya Health is a precision neuromodulation clinic based in Marylebone, London. We work with a range of depressive presentations, from those seeking a drug-free, non-invasive alternative to antidepressants, to those living with treatment-resistant depression where medication has not brought lasting resolution.
Your treatment is led by Dr Andy Franklyn-Miller, Chief Medical Officer, and Dr Greg Shields, Consultant Psychiatrist at The London Clinic, alongside a specialist team of neuromodulation clinicians. Each protocol is personalised based on your biometrics, mapped to your NayaScore™, and carefully refined throughout your programme.
TMS therapy for depression is NICE-approved and supported by a substantial and well-established evidence base across depressive presentations. Gentle, non-invasive, and with minimal side effects, it works with the brain’s own capacity for change. Most patients complete up to 20 sessions.
The brain is plastic. It can be measured, rewired, and restored.
Step 1: Your rTMS Treatment for Depression: What to Expect
Your journey begins with a 15-min complimentary online discovery call with one of our specialist clinicians, who will take time to understand your history, your experience of depression, and what you are hoping to achieve. This is followed by a comprehensive NayaScore™ assessment, building an objective, multi-domain picture of your brain health and regulatory capacity. Together, these form the foundation from which your entire treatment protocol is designed.
Step 2: Your Personalised rTMS Programme
Based on your NayaScore™ baseline, your clinical team designs a precision rTMS programme specific to the neural circuits involved in your presentation. Sessions last around 30 minutes, and you remain comfortable and awake throughout with no anaesthesia or recovery time needed. Before each session, NayaState™ preparation primes your brain and nervous system to receive treatment, creating the optimal conditions for neuroplastic change.
Step 3: Ongoing Measurement and Next Steps
NayaScore™ tracks how your brain is restoring and rewiring throughout your programme, giving you and your clinical team a clear, longitudinal view of progress. At the close of treatment, your clinician reviews your outcomes with you and recommends a path forward. For many patients, the brain continues to consolidate change long after the final session.
Precision Depression Treatment · London
Depression has a neurological root. And a neurological path toward restoration.
Depression touches every dimension of how we think, feel and function. The circuits in the brain that govern motivation, energy, cognitive function and emotional regulation can become dysregulated, and for many people, difficult to fully address through medication or therapy alone.
TMS treatment for depression uses gentle, focused magnetic pulses to stimulate targeted regions of the brain, restoring balance to these circuits from within. Repeated sessions directly drive neuroplastic change, gradually rewiring patterns of low mood and cognitive slowing and restoring the brain’s capacity to regulate itself.
At Naya, every treatment is built around the individual. Target brain areas are guided by neurocardiac rTMS metrics and informed by each patient’s NayaScore™, an objective measure of brain health, ensuring stimulation reaches the precise circuits involved in their presentation. Before each session, NayaState™ prepares the brain and nervous system to receive treatment, optimising conditions for change.
Depression is one of the most common conditions in the world. Precision neuromodulation is changing what treatment can achieve.
330 million people worldwide live with depression. Medication and therapy have an important role to play, and for many they bring meaningful relief. For others — particularly those finding antidepressants not working — a more precise approach to the underlying neural circuits is what makes the difference.
rTMS is a NICE-approved gentle brain stimulation treatment for treatment-resistant depression in the UK, with an established and compelling evidence base across depressive presentations. At Naya, we combine that science with objective measurement at every stage, building a clearer picture of what is happening in the brain and refining treatment in response.
rTMS for Depression: Precision Care for Every Presentation
When antidepressants aren’t working
For those who have tried medication, therapy, or both, and found that lasting resolution has remained out of reach, precision rTMS for depression offers a more direct route to the neural circuits involved. It is one of the most clinically grounded alternatives to antidepressants available — gentle, targeted, and guided by objective measurement throughout, working at the neural circuits underlying depression with a level of precision that complements and builds on what has come before.
For those seeking a drug-free approach to depression
For many people, the opportunity to address depression without medication is itself meaningful. rTMS is gentle, non-invasive and very well tolerated, with no systemic side effects and no recovery time needed after sessions. It works directly and precisely at the neural circuits driving depression, leaving daily life entirely undisturbed. A clinically grounded approach to gentle brain stimulation for depression, built around you from the outset.
Depression alongside anxiety, chronic fatigue or chronic pain
Depression rarely exists in isolation. For those living with depression alongside anxiety, chronic fatigue syndrome, or chronic pain, Naya’s precision neuromodulation approach works across the shared neural circuits underlying these conditions. Each rTMS protocol is personalised, informed by NayaScore™ biometric data, and refined with care throughout your programme at our London clinic.
NAYASCORE™ IS PROPRIETARY TO NAYA HEALTH AND UNAVAILABLE AT ANY OTHER CLINIC
NayaScore™: Objective Measurement at Every Stage of Your Depression Treatment
Traditionally, brain health has been measured subjectively. NayaScore™ changes this, bringing objective, biological measurement to every stage of your depression treatment, tracking what is actually changing in the brain and nervous system as it unfolds.
Drawing on heart rate variability, cognitive function, metabolic markers and clinical assessment, it builds a precise neurological baseline that reflects your brain’s regulatory capacity — a measurable foundation from which to restore, regulate and rewire.
Tracked and updated throughout your rTMS programme in London, NayaScore™ gives you and your clinical team a clear, longitudinal view of how your brain is responding, where it is heading, and what is changing beneath the surface.
the role of precision rtms in treatment outcomes
NayaScore™: what objective measurement makes possible
1. Precision targeting. Your rTMS protocol is mapped to the specific neural circuits involved in your depression, ensuring stimulation reaches exactly where it is needed.
2. Objective evidence of change. As your treatment for depression progresses, NayaScore™ tracks how your brain is responding, giving you a clear, measurable picture of what is shifting across your programme.
3. A shared clinical picture. Your NayaScore™ data is visible to your wider clinical team, whether that is your GP, psychiatrist or therapist, creating a joined-up view of your neurological health and treatment progress.
4. A longitudinal record of your brain health. NayaScore™ builds over time, tracking your neurological baseline across months and years, so that changes are identified early and responded to with precision.
The Evidence
rTMS is a NICE-approved treatment for depression, recommended by the NHS and supported by decades of clinical research. The evidence base is well established and continues to grow. A landmark Stanford University study (Cole et al., 2021) found that up to 87% of participants experienced meaningful clinical improvement, with significant reductions in depressive symptoms across the cohort. At Naya, we aim to further elevate these outcomes through our neurocardiac-guided approach, personalising treatment targets to each individual's biology via heart-brain coupling
rTMS for Depression:
Safe, Gentle, and Well Tolerated
Precision care that is gentle on the nervous system
rTMS is extremely safe and one of the most well-tolerated approaches to treating depression available. For those who have experienced the side effect burden of antidepressants, this is one of the most significant aspects of what precision neuromodulation offers.
Where side effects occur, they are mild and transient. The most commonly reported are a mild headache on the night of treatment, or some fatigue, which can easily be addressed by simply reducing the frequency of sessions.
Beyond these, the only clinically significant risk associated with rTMS is seizure, occurring in fewer than 0.0016% of treatments, considerably lower than the approximately 0.1% risk associated with medications often prescribed for depression. It has never occurred at Naya Health. We screen thoroughly prior to treatment to identify and minimise any potential susceptibility.
heart-brain coupling for personalised rtms
The heart-brain connection: personalised rTMS guided by your biology
The relationship between the heart and the brain runs deeper than most people realise. The neural networks that govern mood, stress and emotional regulation are the same networks that control autonomic cardiac function. In depression, this system is frequently dysregulated, and the heart provides a measurable, accessible window into that state.
At Naya, we use this connection to guide precision rTMS. By measuring heart rate response across multiple stimulation sites, we identify the precise target that most effectively engages each individual’s regulatory brain network. Precision care of this kind means treatment is selected based on measurable physiological response, not protocol convention.
Naya is currently the only clinic in the UK offering neurocardiac-guided rTMS.
FAQ
What are the options if antidepressants are not working for depression?
If antidepressants haven't given you the relief you were hoping for, you're not alone, and you haven't run out of options. There are several well-researched paths forward: combining medication with therapy, adding a second treatment to support what you're already taking, or exploring NICE-approved approaches like rTMS, esketamine, or ECT. At Naya Health in London, rTMS is offered as a gentle, non-invasive treatment for people who haven't found what they need through standard routes. It's personalised to you, and it might be the thing that finally makes a difference.
What is treatment-resistant depression?
Treatment-resistant depression (TRD) is defined clinically as depression that has not achieved adequate remission after at least two antidepressant trials of adequate dose and duration, typically 4–6 weeks at a therapeutic dose, taken consecutively. Approximately one in three people treated for depression will experience TRD. It is not a different illness from depression; it is depression that has not responded to the most commonly prescribed pharmacological treatmen
Is rTMS used for treatment-resistant depression in the UK?
Yes. rTMS (repetitive transcranial magnetic stimulation) is NICE-approved for treatment-resistant depression in the UK. It is recommended by NICE specifically for patients who have not responded to at least one antidepressant trial, based on substantial evidence from randomised controlled trials demonstrating its efficacy over sham stimulation. NHS availability of rTMS for TRD is limited due to resource constraints, but it is available privately at specialist clinics, including Naya Health in London.
How long does rTMS take to work for treatment-resistant depression?
Most patients with treatment-resistant depression notice improvements in mood and energy within 2–3 weeks of a standard rTMS course, often around sessions 10–15. Some respond earlier, while others improve after treatment as neuroplasticity consolidates. With the accelerated TMS, response may appear within days, with some achieving remission within a week. Our NeuroScore™ monitoring tracks neurological changes, helping identify response patterns and adjust treatment.
Can I continue my antidepressant medication while having rTMS?
Yes, in most cases, rTMS can be delivered safely alongside ongoing antidepressant medication. rTMS works through a neurological mechanism, modulating the electrical activity of cortical circuits, rather than a pharmacological one, and does not interact with antidepressants at a drug-drug interaction level. Many patients at Naya Health continue their current antidepressant regimen throughout their rTMS course. The decision to continue, taper, or stop medication is always made in consultation with the patient's prescribing doctor. Naya does not unilaterally advise on medication changes.
What are the side effects and risks of rTMS compared with medication?
rTMS has a more favourable side-effect profile than antidepressants. Because it is localised, systemic effects like weight gain, sexual dysfunction, emotional blunting, GI issues, sleep disruption, and discontinuation symptoms do not occur. The most common effects are mild scalp discomfort during sessions and occasional short-lived headaches early in treatment. The most serious risk is seizure, which is rare (less than 1 in 10,000 sessions) and largely mitigated with proper screening.
Is there a drug-free treatment for long-term depression in London?
Yes. rTMS is the leading evidence-based, drug-free treatment for long-term and treatment-resistant depression available in London. It is NICE-approved, non-invasive, and requires no medication before, during, or after treatment. Psychological therapies, such as CBT, psychodynamic therapy, and EMDR, are also drug-free but work at a cognitive rather than neurological level and are less effective for chronic, entrenched depression that has not responded to earlier treatment.
How effective is rTMS for depression? What does the evidence show?
If you've been told you're treatment-resistant, it's worth knowing that rTMS has a strong track record with exactly that group. More than 30 randomised trials have found that between half and two-thirds of patients respond, and around a third go into full remission. That's meaningful. At Naya Health, early outcomes have been even more positive, with over 90% of patients reporting genuine improvement. Results will always vary from person to person, but the picture these numbers paint is one of real, achievable hope.
What is the difference between TMS and rTMS?
TMS is the broad term for treatments using magnetic pulses to modulate brain activity. rTMS is the clinical form, delivering repeated pulses to produce lasting neuroplastic changes, unlike single-pulse TMS used diagnostically. Treatment protocols for rTMS are carefully designed to target specific brain regions associated with mood regulation.
What does Naya's approach to depression differ from a standard psychiatry appointment?
Most depression appointments end the same way: a prescription, a referral, or both. There's real value in that, but it doesn't answer the deeper question of what's happening in your brain, or what your brain specifically needs. At Naya, treatment begins with the NeuroScore™ assessment, which looks at the neurological patterns underlying your depression. Your progress is tracked throughout with the same care and objectivity, so you always know where you stand. This isn't a one-size-fits-all protocol. It is a treatment built around how your brain actually works.