“A systematic review of non-invasive neurostimulation for the treatment of depression during pregnancy”

Konstantinou, Gerasimos; Vigod, Simone N.; Mehta, Shobha; Daskalakis, Zafiris J.; Blumberger, Daniel M.

doi:10.1016/j.jad.2020.03.151

Cited by 14 publications

(11 citation statements)

References 83 publications

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“…However, KMAP-DD 2021, recommended rTMS as a first-line treatment for pregnant patients with severe MDD. This recommendation was in line with recent evidence that non-invasive neurostimulation including rTMS could be an effective and feasible alternative treatment for antenatal depression [ 67 , 68 ] and MDD patients with specific psychiatric comorbidities [ 69 ]. Moreover, CANMAT 2016, considers rTMS a first-line treatment for MDD patients who have failed at least one AD treatment [ 43 ], while KMAP-DD 2021, recommended rTMS as the second-line treatment.…”

Section: Comparisons Of Treatment Options Across Treatment Guidelinessupporting

confidence: 73%

The Korean Medication Algorithm Project for Depressive Disorder 2021: Comparisons with Other Treatment Guidelines

Woo

Bahk

Seo

et al. 2022

Clin Psychopharmacol Neurosci

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The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) first was published in 2002, and has been revised four times, in 2006, 2012, 2017, and 2021. In this review, we compared recommendations from the recently revised KMAP-DD 2021 to four global clinical practice guidelines (CPGs) for depression published after 2010. The recommendations from the KMAP-DD 2021 were similar to those from other CPGs, although there were some differences. The KMAP-DD 2021 reflected social culture and the healthcare system in Korea and recent evidence about pharmacotherapy for depression, as did other recently published evidence-based guidelines. Despite some intrinsic limitations as an expert consensus-based guideline, the KMAP-DD 2021 can be helpful for Korean psychiatrists making decisions in clinical settings by complementing previously published evidence-based guidelines, especially for some clinical situations lacking evidence from rigorously designed clinical trials.

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Section: Comparisons Of Treatment Options Across Treatment Guidelinessupporting

confidence: 73%

The Korean Medication Algorithm Project for Depressive Disorder 2021: Comparisons with Other Treatment Guidelines

Woo

Bahk

Seo

et al. 2022

Clin Psychopharmacol Neurosci

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“…These findings concerning the safety profile and tolerability are in line with our results. This kind of satisfaction may be explained by giving care to patients who have constant difficulties in finding adequate treatment for their complaints [ 32 ]. Lack of time due to household, children, and work could be another issue in this population [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…This kind of satisfaction may be explained by giving care to patients who have constant difficulties in finding adequate treatment for their complaints [ 32 ]. Lack of time due to household, children, and work could be another issue in this population [ 32 ]. Therefore, self-administered tDCS at home could be helpful to ease access to treatment [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Transcranial Direct Current Stimulation (tDCS) for Depression during Pregnancy: Results from an Open-Label Pilot Study

et al. 2021

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Introduction: Depression is the most common morbidity during pregnancy. Available first-line therapy options are limited and depressive disorders in pregnant women are often untreated, leading to negative effects on maternal and fetal health. Objectives: The aim of this open-label pilot study is to extend evidence on the use of transcranial direct current stimulation (tDCS) as a treatment of antenatal depression and to point out options for the use of tDCS in this population. Methods: Six drug-free female patients with major depressive disorder during pregnancy (later than 10th gestational week) were included in this pilot study. Patients were treated with twice-daily tDCS (2 mA, 30 min, anode: F3, cathode: F4) over ten days during inpatient stay (Phase 1) and with once-daily tDCS over 10 days during an optional outpatient stay (Phase 2). Clinical (HAMD-21, BDI) and neuropsychological ratings (Trail Making Test A/B) were performed at baseline, after two and four weeks as well as an obstetric examination. Results: Six right-handed females (23–43 years, 12–33. gestational week) completed Phase 1; four patients additionally joined in Phase 2. tDCS was well tolerated and no adverse effects occurred. Clinical ratings showed an improvement of mean baseline HAMD-21 from 22.50 ± 7.56 to 13.67 ± 3.93 after week 2, and to 8.75 ± 4.99 after week 4. The mean baseline BDI was 26.00 ± 13.90 and declined to 11.17 ± 5.46 after week 2, and to 9.25 ± 3.30 after week 4. Conclusions: Statistically significant changes in HAMD-21 and BDI were observed after Phase 1. One patient achieved remission in terms of HAMD in Phase 1. Although this small-scale study lacks sham control, it shows clinical improvement and absence of adverse events in this critical population.

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“…The aims of our review were to identify available studies about tES during pregnancy and the postpartum period in order to investigate its efficacy and safety during the perinatal period. To our knowledge, several reviews have addressed this topic [ 56 , 57 , 58 ], but the present research has the advantage of including a larger number of studies independently of diagnosis and type of tES used. Thus, we highlighted the complete absence of available data on the use of tES in postpartum disorders and during breastfeeding, including postpartum depression.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Transcranial Electric Stimulation during the Perinatal Period: A Systematic Literature Review and Three Case Reports

Laurin

Nard

Dalmont

et al. 2022

JCM

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Introduction: The perinatal period is an at-risk period for the emergence or decompensation of psychiatric disorders. Transcranial electrical stimulation (tES) is an effective and safe treatment for many psychiatric disorders. Given the reluctance to use pharmacological treatments during pregnancy or breastfeeding, tES may be an interesting treatment to consider. Our study aims to evaluate the efficacy and safety of tES in the perinatal period through a systematic literature review followed by three original case reports. Method: Following PRISMA guidelines, a systematic review of MEDLINE and ScienceDirect was undertaken to identify studies on tES on women during the perinatal period. The initial research was conducted until 31 December 2021 and search terms included: tDCS, transcranial direct current stimulation, tACS, transcranial alternating current stimulation, tRNS, transcranial random noise stimulation, pregnancy, perinatal, postnatal, and postpartum. Results: Seven studies reporting on 33 women during the perinatal period met the eligibility criteria. No serious adverse effects for the mother or child were reported. Data were limited to the use of tES during pregnancy in patients with schizophrenia or unipolar depression. In addition, we reported three original case reports illustrating the efficacy and safety of tDCS: in a pregnant woman with bipolar depression, in a pregnant woman with post-traumatic stress disorder (sham tDCS), and in a breastfeeding woman with postpartum depression. Conclusions: The results are encouraging, making tES a potentially safe and effective treatment in the perinatal period. Larger studies are needed to confirm these initial results, and any adverse effects on the mother or child should be reported. In addition, research perspectives on the medico-economic benefits of tES, and its realization at home, are to be investigated in the future.

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“A systematic review of non-invasive neurostimulation for the treatment of depression during pregnancy”

Cited by 14 publications

References 83 publications

The Korean Medication Algorithm Project for Depressive Disorder 2021: Comparisons with Other Treatment Guidelines

The Korean Medication Algorithm Project for Depressive Disorder 2021: Comparisons with Other Treatment Guidelines

Transcranial Direct Current Stimulation (tDCS) for Depression during Pregnancy: Results from an Open-Label Pilot Study

Efficacy and Safety of Transcranial Electric Stimulation during the Perinatal Period: A Systematic Literature Review and Three Case Reports

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