Transcranial magnetic stimulation in the treatment of peripartum bipolar depression: a case report

Xiong, Willa; Lopez, Ruthzaine; Cristancho, Pilar

doi:10.1590/1516-4446-2018-0037

Cited by 14 publications

(4 citation statements)

References 5 publications

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“…[79]. Other case-reporting [81,82] also succeeded in improving patients with PPD using rTMS. Although parameters that can affect therapeutic effects such as stimulation site, frequency, and interval time are still being studied, thare are not much research data, we have been able to con rm that there is therapeutic effect without relying on multiple parameter settings on the literature collected, and if the protocol becomes more sophisticated, we will have a higher therapetic effect.…”

Section: Discussionmentioning

confidence: 98%

“…Except for Garcia study [62] which is expected reporting bias because of selection report, SMD = 1.074 (95% CI: 0.689-1.459, Z = 5.468, p < 0.001) which is meaningful result. The literature not included in the meta-analysis and excluded literature because those are not suitable selection criteria also supprot the therapeutic effect of rTMS for PPD [64,[66][67][68][69][70][78][79][80][81][82]. In a studies included systematic review, 36% of the patients with PPD scored the same as the normal person and 66% saw their depression rating scale decrease by more than 50%.…”

Section: Discussionmentioning

confidence: 99%

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Treatment Repetitive Transcranial Magnetic Stimulation to Peripartum Depression: Systematic Review

Lee¹,

Kim²,

Kwon³

2020

Preprint

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BackgroundPeripartum depression is a common disorder; it has very high potential hazards for both patients and their babies. Although peripartum depression therapy have typical options, antidepressant and electroconvulsive, these are not ensured concerning safe of fetus. Recently, repetitive Transcranial Magnetic Stimulation(rTMS) have been emerging as promising treatment for neuropathies including type of depression. Using magnetic field is expected to minimize effect on fetuses when used to treat peripartum depression. In this study, we are considering that whether the rTMS treatment is safe and effective for the mother and fetus in the treatment of peripartum depression.PurposePerforming systematical review, we confirm whether repetitive Transcranial Magnetic Stimulation is suitable treatment option for peripartum depression. MethodsA systematic review followed the PRISMA guidelines and meta-analysis was performed by CMA3 software. We investigated literature prior to July 2020 using databases including MEDLINE, PsycINFO, EMBASE and Cochrane libraries, and conducted bias evaluation for suitable literature. ResultsrTMS have an effect on mitigating depression with SMD = 1.394, 95% CI: 0.944 – 1.843 and. 37% of participants showed remission of the depression and 66% showed responded to repetitive Transcranial Magnetic Stimulation. A few side effect was reported and case of unusual side effect was two. However, we confirmed these are not related to TMS. There were no life-threatening side effects.ConclusionsrTMS might be an attractive alternative treatment for pregnant women who are afraid of chemical effect to their child and life threatening side effect of ECT. Furthermore, rTMS could reduce socioeconomic costs of peripartum depression However, much research is needed to determine standardized protocol and evaluate effectiveness.Systematic review registrationThis systematic review was not registered.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Treatment Repetitive Transcranial Magnetic Stimulation to Peripartum Depression: Systematic Review

Lee¹,

Kim²,

Kwon³

2020

Preprint

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“…In Brock’s study, 14 out of 19 patients with rTMS achieved remission [ 70 ], and in Ozmut’s study, eight out of 15 patients responded to rTMS [ 71 ]. Other studies also succeeded in improving the depression of patients with PPD using rTMS [ 72 , 73 ]. It could be possible that the effect size was overestimated because the parameters that can affect the treatment effect, such as the site of stimulation, frequency, and interval time, were not established, and there was a risk of bias.…”

Section: Discussionmentioning

confidence: 99%

Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

Lee

Kim

Kwon

2021

BMC Pregnancy Childbirth

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Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

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“…Ozmut's study, eight out of 15 patients responded to rTMS [73]. Other studies also succeeded in improving the depression of patients with PPD using rTMS [74,75]. It could be possible that the effect size was overestimated because the parameters that can affect the treatment effect, such as the site of stimulation, frequency, and interval time, were not established, and there was a risk of bias.…”

Section: Discussionmentioning

confidence: 99%

Repetitive Transcranial Magnetic Stimulation Treatment for Peripartum Depression: Systematic Review & Meta-Analysis

Lee

Kim

Kwon

2020

Preprint

View full text Add to dashboard Cite

BackgroundPeripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. MethodsWe performed a systematic review followed the PRISMA guidelines. We searched studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method.ResultsThe therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.920 – 1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.777 – 1.233), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346, (95% CI: 0.214 – 0.506), which was a meaningful result. There were no serious side effects to the mothers or fetuses.ConclusionsFrom a variety of perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid the exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

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Transcranial magnetic stimulation in the treatment of peripartum bipolar depression: a case report

Cited by 14 publications

References 5 publications

Treatment Repetitive Transcranial Magnetic Stimulation to Peripartum Depression: Systematic Review

Treatment Repetitive Transcranial Magnetic Stimulation to Peripartum Depression: Systematic Review

Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

Repetitive Transcranial Magnetic Stimulation Treatment for Peripartum Depression: Systematic Review & Meta-Analysis

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Transcranial magnetic stimulation in the treatment of peripartum bipolar depression: a case report

Cited by 14 publications

References 5 publications

Treatment Repetitive Transcranial Magnetic Stimulation to Peripartum Depression: Systematic Review

Treatment Repetitive Transcranial Magnetic Stimulation to Peripartum Depression: Systematic Review

Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

Repetitive Transcranial Magnetic Stimulation Treatment for Peripartum Depression: Systematic Review &amp; Meta-Analysis

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Repetitive Transcranial Magnetic Stimulation Treatment for Peripartum Depression: Systematic Review & Meta-Analysis