By Suzanne Kerns, M.D.

Women who suffer from depression during pregnancy or in the postpartum period might not seek treatment if they assume medication is the only treatment option available to them. Although concerns about taking medication while pregnant or breastfeeding are understandable, untreated depression can also be very dangerous.

Women who want to avoid or limit the use of antidepressants may consider Transcranial Magnetic Stimulation (TMS) as a safe and effective treatment option. Approved by the FDA in 2008 for treating depression, TMS works by delivering electromagnetic pulses to specific areas of the brain that regulate mood.

A standard treatment course is five sessions a week for four-to-six weeks. Each session lasts about one hour. Patients remain awake and alert during the treatment, and there are minimal side effects.

Several research findings have shown that TMS is a safe and viable treatment for women who are pregnant or postpartum.

• A University of Pennsylvania study of TMS and pregnancy found that among 10 pregnant women treated with TMS, 70 percent responded well within just 20 sessions, with no adverse effects on pregnancy or fetal outcomes. The only side effect was a mild headache in four of the patients.[1]
• Another study that focused on TMS during postpartum found that eight of the nine women who were treated with TMS experienced complete remission of their depression.[2]

In addition to being safe and effective for patients, TMS has not been shown to have adverse effects on a fetus or nursing child. A recently published study looking at 26 children ages one to five years old, whose mothers had received TMS treatment during pregnancy, found there were no differences between the children born to women who had TMS during pregnancy and children born to women who did not undergo TMS.[3]

TMS’s safety and effectiveness make it an ideal option for women with a history of non-response to standard antidepressant medications that are deemed safe in pregnancy or for women who don’t want to take medication during pregnancy or while breastfeeding. Unlike antidepressant medication, TMS does not enter the bloodstream, and therefore does not have any known or foreseeable effects on a fetus or nursing child.

[1] Kim, DR, Epperson, N, Paré, E, Gonzalez, JM, Parry, S, Thase, ME, Cristancho, P, Sammel, MD, O’Reardon, JP. (2011) An open label pilot study of transcranial magnetic stimulation for pregnant women with major depressive disorder. Journal of Women’s Health 20(2): 255-261.

[2] Garcia, KS, Flynn, P, Pierce, KJ, Candle, M. (2010) Repetitive transcranial magnetic stimulation treats postpartum depression. Journal of Brain Stimulation 3(1): 36-41.

[3] Eryılmaz, G, Sayar, GH, Özten, E, Gül, IG, Yorbik, O, Işiten, N, Bağci, E. (2015) Follow-Up Study of Children Whose Mothers Were Treated With Transcranial Magnetic Stimulation During Pregnancy: Preliminary Results. Journal of Neuromodulation 18(4): 255-60.