What To Expect?

Our unique patented bipolar treatment programme begins with an expert assessment from Dr Andy Zamar, an internationally-renowned authority in treatment-resistant affective disorders. Dr Zamar invented the protocol for our treatment programme. Your appointment with him will be up to 1 hour and 30 minutes. It will include:

• A unique psychiatric evaluation assessing for subthreshold symptoms
• An assessment for High-Dose Levothyroxine (HDL) which will include:
  • Genetic testing (mouth swab)
  • Blood analysis
  • An electrocardiogram (ECG)
• Detailed written report

Following this appointment, you will receive a report which will detail your condition and treatment plan.

If Dr Zamar assesses you are suitable for our treatment programme, he will refer you to another consultant (your treating consultant) at The London Psychiatry Centre who will see you through the programme. You will see this consultant weekly for monitoring and tests as required.

If you are already a patient being treated by a consultant at The London Psychiatry Centre and they think you could benefit from high-dose Levothyroxine added to your treatment, you will need to have Dr Zamar’s opinion before you start the treatment.

If a treatment threshold is reached, you may also need to see Dr Zamar for further assessment. Your treating consultant can discuss this with you in more detail. If you would like to remain under Dr Zamar’s care, the costs of the consultations are higher (please see our How Much Will It Cost? and Fees pages).

Following the results of your initial tests, your treating consultant will be able to provide you high-dose Levothyroxine, personalised to your body’s needs. Some patients will also need one additional medication. If you suffer from treatment-resistant bipolar type I, you may need an additional two medications.

You will need to attend the clinic for your course of Repetitive Transcranial Magnetic Stimulation (rTMS) treatment. The exact length of this will vary between individuals, but a usual time frame is around 8 weeks.

Can I Opt For Only Part of the Treatment Programme?

You can choose to see a consultant and opt for rTMS alone, but if you do not recover and require high-dose Levothyroxine, you will need to see Dr Zamar. Our success rates using both rTMS and high-dose Levothyroxine are substantially higher (96.4%) than using rTMS alone (59% of women, 62% of men), or high-dose Levothyroxine alone (which increases time in ‘normal’ moods but does not give full recovery).

Using both interventions we treat the mitochondria, the unit of the cell producing energy for the cell to function as well as recover, as explained in this peer-reviewed article we published in the medical journal Frontiers in Psychiatry.

Will I Need To See Anyone Else?

All mood disorder patients must be seen by a cardiologist, because 4 in 10 people with bipolar disorder suffer early death by 10 years from heart disease. In addition, depression increases death rates 4-fold in men and 14-fold in women (age groups 17-39). Here at The London Psychiatry Centre we refer to one of Britain’s most eminent cardiologists and we are the only clinic in the UK taking this preventive step routinely with all our patients.

During the treatment programme it may also be recommended that you are monitored and reviewed by an endocrinologist.

We can make a referral to these specialists on your behalf, however you are free to see whom you choose. The London Psychiatry Centre does not have any financial affiliation with these professionals. We do, however, refer to them regularly and they are familiar with the treatment programme. We are unable to provide any guide as to the costs of consultations or any tests they may recommend as it would depend on who you choose to see and their professional opinion.

What Treatment Results Can I Expect?

Our most recent published paper shows that with our treatment programme:

• Patients need an average of 1.8 drugs, with 58% requiring only one drug.
• 96% of patients had full remission for an average of 2 years (2 years, not because they relapsed after this time but because the observation period was for an average of 2 years).
• After treatment, patients experienced a significant reduction in disability rating, from an average of 7.4/10 down to 1.29/10. 33% of patients had a disability rating of 0/10.*
• Treatment is generally well tolerated with few, if any side effects.
• Drugs that are prescribed as part of the treatment programme are well tolerated for many years.
• Patients recovered after years of unsuccessful treatment with traditional methods.

*The Sheehan Disability Scale (SDS) disability rating is used to determine how serious symptoms and/or side effects are and how much they impact your life.

We will diligently look for and exclude/treat the most common causes of mortality such as cardiovascular mortality in mood disorders.

Read more details about our treatment results.

How Long Will Treatment Take?

It is difficult to predict with certainty how long treatment will take for a patient to reach  remission. Our published paper shows that 50% of our patients will recover fully in 10.5 weeks. In some cases, you may reach remission sooner than the average stated period, whilst others may take longer to achieve remission.

How Much Will Treatment Cost?

The treatment cost will be different depending on your choice of consultant and how long it takes to reach remission. We have provided an estimate of costs and a breakdown of this here.