The culmination of safety studies looking at antidepressant medications is likely to result in low but established rates of teratogenicity and perinatal complications. Further epidemiologic data will likely establish the low but significant rate of complications related to untreated depression during pregnancy and add to the importance of the availability of lower or negligible-risk treatment alternatives. Women burdened with decisions informed by these studies may opt to undergo treatment for depression, but find any documented fetal risk to be unsatisfactory. Research on alternative treatments for depression should expand upon current findings, showing exercise therapy, phototherapy and accupuncture to be effective treatment strategies for depression with studied effect sizes similar to those for pharmaceutical and psychotherapeutic treatments for mild-to-moderate depression. Further studies of ECT will help quantify its perinatal risks, and inform the cost–benefit decisions made for the treatment of severe MDEs. Controlled trials of TMS in pregnant women will likely mirror the moderate to large effect sizes already shown for MDD, potentially offering pregnant women a time-intensive but safe procedure for more treatment-refractory MDEs.
Financial & competing interests disclosure
Deborah Kim has received support from Neuronetics, Inc.The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.
Women's Health. 2010;6(4):565-576. © 2010 Future Medicine Ltd.
Cite this: Unipolar Depression During Pregnancy: Nonpharmacologic Treatment Options - Medscape - Jul 01, 2010.