Perinatal Depression

Transcranial magnetic stimulation has far fewer side effects than antidepressant medications. With more than 10,000 treatments performed in clinical trials, the most common side effect was temporary and mild scalp discomfort during active treatment. Unlike medications, which affect the entire body as they pass through the blood-brain barrier, TMS therapy treats the brain directly.

Transcranial magnetic stimulation therapy for depression is FDA-cleared and covered by most insurance including Aetna, Anthem, Blue Shield, Optum, MHN/Healthnet, Tricare, Cigna, Magellan and Beacon and more.

Our phenomenal clinical team is always available to help prospective patients understand their coverage options. We know how important it is that those seeking help are able to get the treatment they need. Not to mention, at Neuro Wellness Spa, we handle all the paperwork.

Although TMS is not yet FDA indicated for use during pregnancy, current evidence of rTMS for depression during pregnancy is highly encouraging and many peripartum providers are recommending TMS as a safer treatment option.

Pregnancy:

In 2011, Kim and colleagues treated 10 depressed pregnant women during the 2nd or 3rd trimester employing. With this approach, 7 women achieved response (i.e., at least a 50% reduction from baseline scores) as assessed with the 17-Item Hamilton Depression Rating Scale (HDRS-17). Four patients reported mild headaches but there were no other adverse events.

In 2014, Hizh Sayar and colleagues treated 30 pregnant woman during the 1^st, 2nd or 3rd trimester employing 18 sessions of 25 Hz TMS at 100% motor threshold applied over the left dorsal lateral prefrontal cortex.  Notably, there was a significant decrease in the mean HDRS-17 score from baseline (p < 0.001) after the treatment course. There were no reported adverse maternal or fetal events.

Neonatal Outcomes:

In a 2015 case control study, Erylimaz and colleagues compared the children of mothers who received treatment with TMS during pregnancy (n=30) to a control group of children whose mothers went untreated for their prenatal depression (n=26). In the control group, 3 infants had jaundice and 1 had a low birth weight. In the TMS group, 2 infants had jaundice and 1 had febrile seizures. Further, there were no significant cognitive or motor delays in the offspring of mothers treated with TMS.

Postpartum Depression:

In 2010, Garcia and colleagues treated 9 women with postpartum depression employing 20 sessions of 10 Hz TMS at 120% motor threshold applied over the left dorsal lateral prefrontal cortex. By week 2, patients experienced significant improvement in depressive symptoms from baseline (p<0.008) as assessed with the 24-Item HDRS scale. Furthermore, 8 patients achieved remission (ie., HDRS-24 < 10 and Clinical Global Impressions Severity Scale =1) at week 4 and 7 patients still met remission criteria at 6 months.

In 2012, Myczkowski and colleagues treated 14 women with postpartum depression employing 20 sessions of 5 Hz TMS at 120% motor threshold or a sham procedure applied over the left dorsal lateral prefrontal cortex. Active TMS yielded improvement at week 6 as assessed with the HDRS-17. Two patient’s reported mild scalp pain but there were no other adverse events.

At Neuro Wellness Spa in Los Angeles, mothers may bring their infants or children with them to their TMS appointments. During the TMS treatment, mothers may hold their infants or support staff may be utilized to help provide childcare.