2026 ECNP Congress

PS04-4121

Transcranial direct current stimulation (tDCS) in perinatal depression: a naturalistic study of clinical outcomes and tolerability

Sofia Pappa — M. Toynbee, J. Barnett, S. Thapa, M. Simon-Norris, M. Tai, T. Chester, J. Wilson, D. Zygmunt · West London NHS Trust, Neuromodulation, London, United Kingdom

2026 ECNP Congress

Background

Perinatal depression is associated with significant morbidity for both mother and infant, and treatment options may be limited by concerns regarding pharmacotherapy during pregnancy and the postpartum period. Transcranial direct current stimulation (tDCS) has emerged as a non-invasive intervention with a favourable safety profile and good efficacy in the treatment of major depressive disorder in randomised controlled trials and meta-analyses [1,2]. These characteristics make it particularly relevant in perinatal populations, where treatment decisions are often influenced by concerns regarding foetal and neonatal exposure to medication. Despite this, studies examining the use of tDCS specifically in perinatal populations remain limited [3,4].

Methods

In this naturalistic study of perinatal patients (pregnant and postpartum) receiving tDCS for depressive disorders, participants were treated within a secondary NHS care clinical setting. tDCS was offered as an adjunctive or alternative intervention where clinically indicated using a standard treatment protocol. Symptom severity was primarily measured using the Montgomery–Asberg Depression Rating Scale (MADRS) at baseline, 6 weeks, and 12 weeks. Additional measures were available for some patients, including the Patient Health Questionnaire-9 (PHQ-9) at baseline and 12 weeks, and the Work and Social Adjustment Scale (WSAS) at baseline and 6 weeks. Side effects and discontinuation information were recorded throughout. Basic demographic and clinical data, including age, ethnicity, and treatment indication were also collected. Data were analysed descriptively.

Results

A total of 11 patients were prospectively enrolled, of which 9 were included in the analysis; one patient did not commence treatment and one discontinued after a single session in the absence of any reported side effects. The cohort had a mean age of 35.9 years (range 32–42) and included 1 pregnant and 8 postpartum patients; ethnicity was 56% White, 33% Asian, and 11% Black. The most common indications for tDCS use were lack of response to current treatment (56%) and preference to avoid pharmacological options during pregnancy or breastfeeding (33%). All patients, n=9, completed 12 weeks of treatment and mean MADRS scores reduced from 31.1 at baseline to 24.1 at 6 weeks and 22.6 at 12 weeks (27.5% reduction). Among patients with available PHQ-9 data (n=6/9), scores reduced from 19.7 at baseline to 13.0 at 12 weeks (33.9% reduction). The most commonly reported side effects were mild skin irritation (33%) and headache (17%), with no serious adverse effects observed.

Conclusions

In this naturalistic perinatal cohort, tDCS was associated with a reduction in depressive symptoms over 6 and 12 weeks and was well tolerated. These findings are consistent with emerging evidence supporting tDCS as a potential adjunctive or alternative treatment in depression, particularly in populations where pharmacological options may be limited. This study adds to the limited evidence base in perinatal populations and represents one of the first naturalistic evaluations of tDCS in this context. Further studies are required to establish efficacy and optimise treatment protocols in these vulnerable populations.

References

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