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Monotherapy With tDCS for Treatment of Depressive Episode During Pregnancy: A Case Report

Published:March 11, 2016DOI:https://doi.org/10.1016/j.brs.2016.03.007
      Major depressive disorder is common during pregnancy (7–15% prevalence), and untreated depression can adversely impact maternal and fetal health [
      • Muzik M.
      • Marcus S.M.
      • Heringhausen J.E.
      • Flynn H.
      When depression complicates childbearing: guidelines for screening and treatment during antenatal and postpartum obstetric care.
      ]. Antidepressants represent the mainstay treatment for moderate to severe depressive episode; however, when used during pregnancy, they can lead to spontaneous abortions, low birth weight, preterm birth, neonatal cardiovascular malformations, neonatal pulmonary hypertension, fetal death, seizures and long term risk for autism [
      • Ross L.E.
      • Grigoriadis S.
      • Mamisashvili L.
      • Vonderporten E.H.
      • Roerecke M.
      • Rehm J.
      • et al.
      Selected pregnancy and delivery outcomes after exposure to antidepressant medication: a systematic review and meta-analysis.
      ]. It has been observed that the majority of pregnant women with depression (about 80%) do not seek treatment possibly due to the perceived risks with antidepressants [
      • Muzik M.
      • Marcus S.M.
      • Heringhausen J.E.
      • Flynn H.
      When depression complicates childbearing: guidelines for screening and treatment during antenatal and postpartum obstetric care.
      ]. Alternative treatment options like psychotherapy are limited by their suboptimal efficacy as well as longer durations required for clinical improvement, Electroconvulsive therapy in this population is limited by its invasiveness and hence its clinical utility is restricted to severe depression with suicidal risk.
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