title: An open label pilot study of transcranial magnetic stimulation for pregnant women with major depressive disorder.
abstract: OBJECTIVE
  Despite the data that major depressive disorder (MDD) is common during pregnancy and that pregnant women prefer nonmedication treatment options, there is a paucity of research examining alternative treatments for this special population. We present the results of an open label pilot study examining treatment with transcranial magnetic stimulation (TMS) in pregnant women with MDD.
  
  
  METHODS
  Ten women with MDD in the second or third trimester of pregnancy were treated with 20 sessions of 1-Hz TMS at 100% of motor threshold (MT) to the right dorsolateral prefrontal cortex. The total study dose was 6000 pulses. Antenatal monitoring was performed during treatment sessions 1, 10, and 20.
  
  
  RESULTS
  Seven of ten (70%) subjects responded (decrease ≥50% in Hamilton Depression Rating Scale [HDRS-17] scores). No adverse pregnancy or fetal outcomes were observed. All infants were admitted to the well baby nursery and were discharged with the mother. Mild headache was the only common adverse event and was reported by 4 of 10 (40%) subjects.
  
  
  CONCLUSIONS
  TMS appears to be a promising treatment option for pregnant women who do not wish to take antidepressant medications.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. drkim@mail.med.upenn.edu
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Kim
authors.forename: Neill
authors.initials: N
authors.lastname: Epperson
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Paré
authors.forename: Juan M
authors.initials: JM
authors.lastname: Gonzalez
authors.forename: Samuel
authors.initials: S
authors.lastname: Parry
authors.forename: Michael E
authors.initials: ME
authors.lastname: Thase
authors.forename: Pilar
authors.initials: P
authors.lastname: Cristancho
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: John P
authors.initials: JP
authors.lastname: O'Reardon
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D010865:Pilot Projects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology / Q000628:therapy*; D011295:Prenatal Care / Q000379:methods*; D012074:Remission Induction; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D016387:Women's Health; D055815:Young Adult