Treating peripartum depression with repetitive transcranial magnetic stimulation

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This interventional study compares active repetitive transcranial magnetic stimulation (rTMS) with sham rTMS in up to 60 women who are pregnant or up to 12 months post-delivery and have clinically significant depressive symptoms. Participants receive non-invasive brain stimulation to a mood-related brain region, with clinicians and participants blinded to treatment allocation during the main phase. Key outcomes include changes in depressive symptoms, tolerability, and whether improvements persist one month after treatment. The study also collects safety data and may include EEG and ECG recordings, reflecting comprehensive monitoring in a peripartum population.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Women aged 18 years or older
* Currently pregnant or up to 12 months after childbirth at screening
* Current depressive episode or clinically significant depressive symptoms consistent with peripartum depression, confirmed by clinical interview according to ICD-10 criteria
* MADRS score of at least 7 at screening
* Able to understand German or English
* Able to provide written informed consent
* Willing and able to attend study visits and complete rTMS procedures, EEG and ECG recordings, hair and sputum sampling, and study questionnaires
* Stable antidepressant and/or psychotherapy treatment, or no current antidepressant medication and/or psychotherapy; participants should agree to maintain treatment stability during the study where clinically feasible
* Previous rTMS treatment for depression is permitted

Exclusion Criteria:

* Current or past seizure disorder, or previous rTMS-induced seizure
* Primary psychotic disorder
* Acute suicidality requiring a higher level of care
* Contraindications to rTMS, including intracranial metallic implants; implanted neurostimulators; cochlear implants; vagus nerve stimulators; ocular implants; implanted cardiac electrodes or pacemakers; aneurysm coils or clips; ventriculo-peritoneal shunts; or other ferromagnetic or electronic implants in the head or neck
* Clinically significant head injury within the previous 12 months or with relevant residual symptoms
* Unstable or severe medical or obstetric complications that could make participation unsafe, such as preeclampsia or imminent preterm labour requiring intensive management
* Severe substance use disorder that could interfere with safety or study assessments
* Inability to follow study procedures, for example because of cognitive impairment
* Frequent severe migraine, including chronic migraine with status migrainosus, if high-frequency rTMS is considered likely to worsen symptoms, unless the investigator and treating physician determine that participation is safe.

Where it's running

• University Hospital of Psychiatry Zurich (PUK Zürich), Main Campus
  Zurich, Switzerland Recruiting
• Psychiatric University Hospital, Ambulatorium Quadro
  Zurich, Switzerland Recruiting

Study contacts

• Principal investigator: Barbora Provaznikova — Psychiatric University Hospital, Zurich
• Study coordinator: Barbora Provaznikova, Dr. med.
• Email: barbora.provaznikova@uzh.ch
• Phone: +41 58 384 35 12

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.