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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1042

Efficacy and safety of repetitive transcranial magnetic stimulation in peripartum depressive disorder: a structured literature review

EFFICACY AND SAFETY OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION FOR PERIPARTUM DEPRESSIVE DISORDER: A STRUCTURED LITERATURE REVIEW

In a review encompassing twenty-seven reports, repetitive transcranial magnetic stimulation appears to reduce depressive symptoms during pregnancy and the postpartum period and to be generally well tolerated, although the evidence remains limited.

The aim of the review is to synthesize evidence on the efficacy, acceptability, and maternal, fetal, and neonatal safety of repetitive transcranial magnetic stimulation (rTMS) for peripartum depressive disorder (PDD), which occurs during pregnancy or within 12 months after childbirth and affects approximately 11.9% of women. PubMed was searched using relevant keywords and Medical Subject Headings (MeSH); studies were included if they involved adults receiving rTMS for PDD and reported depressive symptom outcomes, maternal, fetal, or neonatal safety, or treatment discontinuation data. Twenty-seven reports met the inclusion criteria: 20 reports on pregnancy (n=99; 1 randomized controlled trial, 3 single-arm studies, and 16 case reports or case series) and 7 reports on the postpartum period (n=202; 1 randomized controlled trial, 3 single-arm studies, 2 case reports, and 1 retrospective comparative study). The distribution of treatment timing during pregnancy was as follows: first trimester, 4 reports; second trimester, 7; third trimester, 1; multiple trimesters, 6; and not reported, 2. Baseline severity was generally moderate to severe in both periods. Concomitant medication use was reported in 13 of 20 studies during pregnancy and 4 of 7 studies in the postpartum period. During pregnancy, conventional rTMS was used in 16/20 studies and theta burst stimulation (TBS) in 4/20; the target region was the prefrontal cortex in 19/20 studies, with predominantly left-sided stimulation, and treatment ranged from 1 to 77 sessions. In the postpartum period, conventional rTMS was used in 5/7 studies and TBS in 2/7; the target was the left dorsolateral prefrontal cortex (DLPFC) in 7/7 studies, and treatment ranged from 11 to 80 sessions. Regarding efficacy, improvement in depressive symptoms was reported in 18 of 20 reports during pregnancy, with one additional report describing successful maintenance treatment; improvement was observed in all 7 postpartum studies. Regarding safety, preterm birth was the most frequently reported adverse perinatal outcome during pregnancy, although its relationship to rTMS remained unclear. No serious adverse events were reported in postpartum studies that provided safety data. The most common side effects were generally transient headache and scalp pain or discomfort, and treatment completion rates were generally high. Small samples, predominantly uncontrolled designs, heterogeneous TMS protocols, and limited long-term safety data preclude definitive conclusions; larger randomized controlled trials using standardized protocols and systematic maternal, fetal, and infant follow-up are needed.

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