By Dr. David Woo - March 15, 2019

Depression can happen to anyone, at any age and any time. Unfortunately, it can also happen to women when pregnant and is sometimes accompanied by feelings of anxiety, stress, and fear. The American College of Obstetricians and Gynecologists estimates that between 14 and 23 percent of pregnant women experience depression. (1)

Depression can and should be treated, even while pregnant. Treatment for depression is most effective when started early and is an important step to ensuring optimal health for the developing baby. So, what depression treatments are safe for pregnant women? First, let’s discuss why it’s important to treat depression while pregnant.  

Why Is it Important to Seek Treatment for Depression While Pregnant?

People are who are depressed are oftentimes less likely to seek treatment or take steps in practicing self-care. (2) For women who are pregnant, this may translate to not seeking appropriate prenatal care and not eating healthy foods that are essential for the health of the mother and the developing baby. Moreover, depression in either the mother or the father during pregnancy is associated with premature birth, which can result in long-term health complications for the child. (3,4)

Which Depression Treatments Can Be Safely Administered During Pregnancy?

Currently, primary treatments for depression include antidepressant medication and therapy. In addition to benefits, there are significant risks associated with antidepressant medications. For example, if taken during the third trimester, babies can experience withdrawal symptoms from the discontinuation of the antidepressant medication, including jitters and respiratory distress. (5)

Additionally, while some antidepressants may be safely administered throughout pregnancy, there is conflicting evidence as to whether certain antidepressants, like SSRIs, are associated with a higher risk of birth defects. (6,7)

If you’re currently taking antidepressant medication and learn that you’re pregnant, make an appointment to see your doctor before making any changes. You may be able to keep taking your medication. Discontinuing the use of your antidepressant can cause a relapse of symptoms or unwanted side effects.

Transcranial Magnetic Stimulation is Safe for Pregnant Women

Transcranial Magnetic Stimulation (TMS) is a six-week, one-course outpatient treatment therapy used to treat depression. TMS targets a specific area of the brain with magnetic pulses that interact with nerve cells in the brain to relieve symptoms of depression. To learn how TMS works to relieve depressive symptoms, click here.

Early studies testing the safety and efficacy of TMS during pregnancy show that treatment was well-tolerated and resulted in a significant decrease of depressive symptoms, with no adverse effects on the pregnancy or to the baby. (8,9,10)

The results from these studies suggest that TMS is a safe and effective treatment for depression in pregnant women. Moreover, TMS, as opposed to antidepressant medications, is not associated with major side effects.

Are You Pregnant and Noticing Signs of Depression?

Talk to your doctor if you’re:

• Pregnant and notice signs of depression
• Already being treated for depression and have recently found out that you’re pregnant
• Planning a pregnancy and are currently being treated for depression

If you’d like to learn more about how TMS can be used to treat depression during pregnancy, contact our office to make an appointment. At Madison Avenue TMS & Psychiatry, we also offer talk therapy either as a stand-alone treatment or as a complement to TMS for treating depression.

Resources:

1. Depression and postpartum depression: Resource overview. The American College of Obstetricians and Gynecologists. Publication date unavailable. Link. Accessed March 12, 2019.

2. Serani, Debra. Why self-care is hard for depressed individuals. Psychology Today. Published February 06, 2017. Link. Accessed March 12, 2019.

3. Liu C, Cnattingius S, Bergström M, Östberg V, Hjern A. Prenatal parental depression and preterm birth: A national cohort study. An International Journal of Obstetrics and Gynaecology. November 2016; 123(12): 1982. Link. Accessed March 12, 2019.

4. The Long-Lasting Effects of Preterm Birth. National Institutes of Health. Published January 25, 2012. Link. Accessed March 12, 2019.

5. Kalra S, Einarson A, and Koren G. Taking antidepressants during late pregnancy: How should we advise women? Canadian Family Physician. August 10, 2005; 10:51(8): 1077–1078. Link. Accessed March 12, 2019.

6. Key findings—A closer look at the link between specific SSRIs and birth defects. The Centers for Disease Control and Prevention. Updated July 08, 2015. Link. Accessed March 12, 2019.

7. Dubovicky M, Belovicova K, Csatlosova K,and Bogi E. Risks of using SSRI / SNRI antidepressants during pregnancy and lactation. Interdisciplinary Toxicology. September 2017; 10(1): 30–34. Link. Accessed March 12, 2019.

8. Kim DR, Epperson N, Paré E, Gonzalez JM, Parry S, Thase ME, Cristancho P, Sammel MD, and O’Reardon JP. An open label pilot study of transcranial magnetic stimulation for pregnant women with major depressive disorder. Journal of Women’s Health. February 2011; 20(2): 255-61. Link. Accessed March 12, 2019.

9. Hızlı Sayar G, Ozten E, Tufan E, Cerit C, Kağan G, Dilbaz N, and Tarhan N. Transcranial magnetic stimulation during pregnancy. Archives of Women’s Mental Health. August 2014; 17(4): 311-5. Link. Accessed March 12, 2019.10. Kim DR, Wang E, McGeehan B, Snell J, Ewing G, Iannelli C, O’Reardon JP, Sammel MD, and Epperson CN. Randomized controlled trial of transcranial magnetic stimulation in pregnant women with major depressive disorder. Brain Stimulation. January 2019; 12(1): 96-102. Link. Accessed March 12, 2019.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.