A 220-patient randomized trial published in JAMA Psychiatry found that six weeks of left dorsolateral prefrontal cortex TMS produced a 58% response rate in women with postpartum depression, comparable to historical response rates for SSRIs and statistically superior to the 28% sham response rate in the trial.
The trial specifically targeted women who were breastfeeding and either declined antidepressants or had inadequate response to a single SSRI trial. TMS was delivered in standard 10Hz sessions five days per week. No serious adverse events occurred. Infants were monitored for developmental milestones and showed no differences from a matched cohort.
Postpartum depression affects roughly 1 in 8 U.S. women and remains substantially undertreated, in part because of concerns about medication exposure during breastfeeding. TMS has long been theorized as an attractive alternative because it is not systemically absorbed, but high-quality controlled data has been limited.
The American College of Obstetricians and Gynecologists is expected to update its perinatal mental health guidance to incorporate the findings later this year.
Source
Reporting based on coverage from JAMA Psychiatry. This article is editorial summary intended for general information; it is not medical advice.