Treatment With Repetitive Transcranial Magnetic Stimulation in Peripartal Depression
Treatment With Repetitive Transcranial Magnetic Stimulation in Peripartal Depression
The goal of this clinical trial is to learn whether repetitive transcranial magnetic stimulation (rTMS) can reduce depressive symptoms in women who are pregnant or up to 12 months after childbirth and have peripartum depression. rTMS is a non-invasive treatment in which a device placed on the scalp delivers gentle magnetic pulses to a brain area involved in mood regulation. It does not involve medication or anaesthesia.
The main questions this study aims to answer are:
Researchers will compare active rTMS with sham rTMS, a treatment designed to feel and sound similar but not to provide effective brain stimulation. Neither participants nor the clinicians assessing depressive symptoms will know which treatment was assigned during the main study phase.
Up to 60 women aged 18 years or older who are pregnant or up to 12 months after childbirth and have clinically relevant depressive symptoms may take part. Participants will:
Each treatment visit lasts about 30 minutes, including preparation, treatment, and a short safety check. Infants may be brought to treatment visits when this can be done safely.
rTMS is generally well tolerated. Possible temporary side effects include headache, scalp discomfort, facial muscle twitching during stimulation, dizziness, or tiredness. A seizure is a very rare but serious possible risk; therefore, people with epilepsy, certain implants, or other relevant risk factors cannot take part.
Participation is voluntary. Participants can pause or stop participation at any time without affecting their usual care. Personal data will be coded and handled confidentially. Women assigned to sham treatment will be offered active rTMS after the blinded study phase, if they wish. The results may help clarify whether rTMS is an effective non-medication treatment option for peripartum depression.
Inclusion Criteria:
Exclusion Criteria:
barbora.provaznikova@uzh.ch+41 58 384 35 12
Peripartum depression is depression that occurs during pregnancy or within the first year after childbirth. It can affect mood, energy, sleep, daily functioning, relationships, and the ability to enjoy pregnancy or early parenthood. Treatment options during this period may be limited because some people prefer to avoid medication, have concerns about medication during pregnancy or breastfeeding, or do not improve sufficiently with their current treatment.
This clinical trial is investigating repetitive transcranial magnetic stimulation (rTMS) as a possible non-medication treatment for peripartum depression. rTMS is a non-invasive treatment in which a coil placed on the scalp delivers short magnetic pulses to a brain area involved in mood regulation. It does not involve surgery, medication, or anaesthesia. rTMS is already used to treat depression in adults; however, more research is needed to understand its effects specifically during pregnancy and after childbirth.
The study will include up to 60 women aged 18 years or older who are pregnant or up to 12 months after giving birth and have clinically relevant depressive symptoms. Before joining the study, interested individuals will receive written study information and have an opportunity to ask questions. Participation begins only after written informed consent has been provided.
At the baseline visit, the study team will review medical, psychiatric, and obstetric history and confirm eligibility. Participants will complete questionnaires about depressive symptoms, wellbeing, quality of life, social support, treatment expectations, and related topics. EEG and ECG recordings will be performed before treatment. Small hair and sputum samples will also be collected to explore stress-related and other hormone levels. These samples will not be used for genetic testing.
Eligible participants will be assigned by chance, in a 1:1 ratio, to receive either active rTMS or sham rTMS. Sham rTMS uses a special coil designed to produce similar sounds and scalp sensations without delivering effective stimulation to the brain. During the main study phase, participants and the clinicians assessing depressive symptoms will not know which treatment has been assigned. This design allows researchers to compare the effects of active rTMS and sham treatment fairly.
Participants will usually receive two sessions per day on five days per week. To accommodate childcare, breastfeeding, fatigue, medical appointments, and other individual needs, the schedule can be adjusted. Participants may receive between one and four sessions per day, with at least 30 minutes between sessions, and must attend at least three sessions per week. Treatment may therefore be completed over approximately 1.5 to 10 weeks. Each visit lasts around 30 minutes, including preparation, treatment, and a safety check. Infants may be brought to treatment appointments when this can be done safely.
The main aim is to determine whether active rTMS reduces depressive symptoms more than sham rTMS from the start to the end of treatment. The study will also assess changes in self-reported mood, quality of life, social support, and other aspects of wellbeing. EEG and ECG recordings will be repeated after treatment. Participants will be contacted by telephone one month after treatment to assess whether any change in depressive symptoms continues. One year after treatment, participants will be invited to complete a short questionnaire about their child's development.
rTMS is generally well tolerated. Possible temporary side effects include headache, scalp discomfort, facial muscle twitching during stimulation, dizziness, or tiredness. A seizure is a very rare but serious potential risk. To reduce risks, individuals with epilepsy, certain metal or electronic implants, or medical or obstetric conditions that could make participation unsafe will not be included. Safety and any side effects will be assessed and documented before or during every treatment session.
Participation is voluntary. Participants may pause or withdraw from the study at any time without affecting their present or future medical care. Personal information will be coded and handled confidentially. Participants assigned to sham rTMS will be offered the option to receive active rTMS after they have completed the blinded study phase. The findings may help determine whether rTMS could become a useful non-medication treatment option for people with peripartum depression.
sara.romer@bli.uzh.ch+41 58 384 26 02
barbora.provaznikova@uzh.ch+41 58 384 35 12
sara.romer@bli.uzh.ch+41 58 384 26 02