Transcranial magnetic stimulation (TMS) is an emerging novel treatment modality for psychiatric disorders, particularly major depression. A device for delivery of TMS was approved by the US Food and Drug Administration for treatment of major depressive disorder in adults. TMS is being studied for a variety of psychiatric disorders, including obsessive-compulsive disorder, post-traumatic stress disorder, and auditory hallucinations in schizophrenia. In this article, we describe TMS and its neurobiologic basis, as well as the efficacy and safety data of TMS with regard to a range of psychiatric disorders.

Electroconvulsive therapy (ECT) is recommended by the American Psychiatric Association Task Force on ECT as a safe and effective treatment of depression throughout pregnancy. We report here administration of ECT in the third trimester of pregnancy in a 33-year-old patient with severe bipolar depression. The patient had a good antidepressant response to ECT. She experienced, however, delayed onset premature uterine contractions at home after her sixth session of ECT (10 hours post-ECT administration). After receiving tocolytics, the patient's contractions did not progress to premature labor. In consultation with the obstetrics team, it was decided to terminate the ECT course earlier than planned. The patient is delivered of a healthy female newborn infant spontaneously at 37 weeks' gestational age. Four months after delivery, the baby's development is progressing normally. This case illustrates that premature contractions in association with ECT during the third trimester of pregnancy may be delayed in onset. Patients and treatment team need to be aware of this possibility, particularly when ECT is conducted on an outpatient basis.