Transcranial magnetic stimulation for treatment of major depression during pregnancy: a review

Abstract

Introduction: Pregnancy is characterized by a high prevalence of mental disorders. Depression is the most common of these disorders and it is a risk factor for negative maternal and child development outcomes. Psychotherapy and pharmacotherapy are conventional and well-established therapeutic options, but some clients fail to respond and the safety of using some pharmacological agents during pregnancy is unclear. Some neuromodulation techniques, such as repetitive transcranial magnetic stimulation (rTMS), have been studied in depressed pregnant women. Objective: To evaluate the safety and efficacy of rTMS for major depression in pregnant women. Methods: The LILACS and PubMed databases were reviewed using the search terms depression, pregnancy and magnetic stimulation. Texts including primary data, published in Portuguese, Spanish, or English, between 1995 and2014, that evaluated depressed pregnant women and used rTMS as the intervention were selected. Papers lacking sufficient data were excluded. Twenty-two texts were initially identified; after applying the inclusion criteria, 12 were selected and analyzed. Results: The studies reviewed reported satisfactory responses to rTMS in acute depressive episodes, as measured using depressive symptom scales. Remission of symptoms was achieved in many cases. The procedure was well tolerated and there were no reports of damage/complications to unborn children. Conclusion:The data available at this time support the efficacy and tolerability of rTMS for depression in pregnant women. Controlled studies should corroborate this conclusion. This review only included studies in three languages and the resulting sample size was not large enough to conduct a meta-analysis.

Transcranial Direct Current Stimulation (tDCS) for Depression during Pregnancy: Scientific Evidence and What Is Being Said in the Media—A Systematic Review

“…However, this is based on only three case reports. These findings are in line with earlier reports on the use of rTMS in depression during pregnancy, where no adverse events were found in several case reports and small studies [39]. Furthermore, follow-up examinations of children being exposed to rTMS during pregnancy revealed no retardation in cognitive or motor development [40].…”

Oscillatory Activities in Neurological Disorders of Elderly: Biomarkers to Target for Neuromodulation

“…TMS is also best avoided during pregnancy as insufficient data are available on effects on the fetus. However, a recent review on mothers treated with rTMS for major depression during pregnancy reports no complications to the unborn children (Felipe and Ferrão, 2016). …”

Repetitive transcranial magnetic stimulation treatment for depressive disorders

“…Several case reports and three studies have suggested that rTMS is efficient in reducing depressive symptoms during pregnancy. Importantly, no negative pregnancy or foetal outcomes were found except for the potential association with preterm birth and mild headache for mothers [50,51]. For patients with MDD and Parkinson's disease, a recent meta-analysis has shown clear antidepressant efficacy of rTMS [52] indicating that medical comorbidities have no negative influence on the antidepressant efficacy of rTMS.…”