Transcranial direct current stimulation in perinatal mental health: current status and future directions

Abstract One in five women in the peripartum period (from pregnancy and up to twelve months after delivery) will experience a mood or anxiety disorder. While pregnant or breastfeeding, 70-80% of women diagnosed with mood/anxiety disorders refuse medication, postpone treatment, or accept treatments below clinical dose. 20-30% might consider antidepressants but quit breastfeeding. Untreated perinatal depression/anxiety has detrimental effects in women’s overall health and wellbeing, negatively impacting infant’s health and development. Additionally, untreated perinatal mental health disrupts the mother-infant dyad and family relationships, representing a heavy burden on societies. Transcranial direct current stimulation (tDCS) is known to have a beneficial effect (with modest effect sizes) in Major Depression, showing a safe profile. tDCS uses portable devices, easily combined with remote health care, and has proven its potential to be transferred to home-based delivered treatments. Despite the available evidence not supporting the need for a general precaution against its use in the perinatal period, researchers, IRBs, regulators and manufacturers keep conveying the idea that tDCS is a high-risk intervention for pregnant or breastfeeding women, leading to a lack of studies about tDCS as an alternative treatment for perinatal disorders. A systematic review of the literature will be presented, about the evidence of efficacy of tDCS to manage depressive/anxiety symptoms in the peripartum period. Further, this review will be informed by qualitative data on the subjective experiences and expectations about tDCS as an alternative treatment to perinatal mental health from women with lived experience of PPD and perinatal mental health professionals. With this data we aim to set the context for future research about the use of tDCS in perinatal mental health and shed light to the needed changes by regulatory bodies, the market, research, and the clinical practice about the usability of tDCS in perinatal mental health. Research Category and Technology and Methods Clinical Research: 9. Transcranial Direct Current Stimulation (tDCS) Keywords: tDCS, Peripartum depression, Efficacy, Acceptability