Investigating novel solutions to treat depression in pregnancy
Affecting up to 10 per cent of pregnant women, major depression is associated with adverse outcomes for both mom and baby and is also the strongest predictor of postpartum depression. Unfortunately, the standard treatments for major depression such as psychotherapy and antidepressant medications are not ideal for pregnant women.
Dr. Simone Vigod, Chief of Psychiatry at Women’s College Hospital and scientist at Women’s College Research Institute, and Dr. Daniel Blumberger, clinician scientist at the Centre for Addiction and Mental Health, recently co-led a pilot study to evaluate the use of transcranial direct current stimulation (tDCS) to treat depression in pregnant women. tDCS is a non-invasive brain stimulation that delivers electrical current to change brain activity.
The study, published in Brain Stimulation, tested the feasibility, acceptance and adherence of tDCS as a potential treatment option for depression in pregnancy. Participants received 15, 30-minute sessions over approximately three weeks. Dr. Vigod and her colleagues found among the women who received tDCS, 87.5 per cent were satisfied or extremely satisfied with the treatment, and 100 per cent reported that they felt it was an acceptable alternative to antidepressants. The tDCS intervention was also well-tolerated by the participants. These findings, in addition to the high completion and long-term follow up rates of 88 per cent, demonstrate the viability of conducting a larger clinical trial to evaluate tDCS as a treatment option.
While this pilot was not set up to measure the effectiveness of tDCS, the improvement in symptoms measured at post-treatment, four and 12 weeks postpartum were very encouraging. The study also showed that 75 per cent of participants who received tDCS had minimal or no symptoms of depression at four weeks postpartum. These results indicate tDCS may also have an additional application as a preventive intervention for women at high risk for postpartum depression.
For next steps, a large clinical trial should be conducted to measure the efficacy of tDCS as a treatment, while also looking at barriers to participation including travel time to appointments and lack of childcare. If shown to be safe and effective, tDCS could be widely used to treat and prevent long-term negative outcomes of depression in pregnant women.