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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyune June Lee ◽  
Sung Min Kim ◽  
Ji Yean Kwon

Abstract 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.

2020 ◽  
Author(s):  
Hyunejune Lee ◽  
Sungmin Kim ◽  
Ji Yean Kwon

Abstract 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.


2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Beppe Micallef-Trigona

Electroconvulsive therapy (ECT) is the longest standing psychiatric treatment available and has unequivocal benefit in severe depression. However this treatment comes with a number of side effects such as memory impairment. On the other hand, Repetitive Transcranial Magnetic Stimulation (rTMS) is a relatively new form of treatment which has been shown to be efficacious in patients suffering from a number of psychopathologies, including severe depression, with few reported side effects. Due to its potential therapeutic efficacy and lack of side effects, rTMS has gained traction in the treatment of depression, with a number of authors keen to see it take over from ECT. However, it is not clear whether rTMS represents a therapeutic alternative to ECT. This meta-analysis will therefore compare the “gold standard” treatment for severe depression, with the relatively new but promising rTMS. A literature search will be performed with the intention to include all randomised clinical trials. The null hypothesis is that there is no difference in the antidepressant efficacy between the two types of treatment modalities. Statistical analysis of Hamilton Depression Rating Scale (HDRS) scores will be performed.


2020 ◽  
Author(s):  
Hyunejune Lee ◽  
Sungmin Kim ◽  
Ji Yean Kwon

Abstract 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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