eng Science and Education Publishing American Journal of Clinical Medicine Research 2328-403X 2014-01-16 2 1 18 21 10.12691/ajcmr-2-1-5 AJCMR2014215 article Eylem Ozten 1 Gokben Hızlı Sayar gokben.hizlisayar@uskudar.edu.tr 1 Işıl Gögcegöz Gül 1 Ali Evren Tufan 2 Cem Cerit 3 Nesrin Dilbaz 3 Uskudar University Medical Faculty, Department of Psychiatry, Istanbul, Turkey AbantIzzetBaysal University Medical Faculty, Department of Child and Adolescent Psychiatry, Bolu, Turkey Kocaeli University Medical Faculty, Department of Psychiatry, Kocaeli, Turkey About 5-10% of women experience depression during pregnancy. The potentially adverse effects of pharmacological treatment (e.g. teratogenicity, toxicity, foetal developmental abnormalities and withdrawal symptoms) on both the mother and the foetus mean that psychopharmacological treatments have limited application for pregnant women. In these cases treatment needs to be tailored to the individual patient and non-pharmacological options may be appropriate. Transcranial Magnetic Stimulation (TMS) and Electroconvulsive treatment (ECT) may be viable alternatives for these patients. We report on three patients in their first trimester of pregnancy suffering from major depressive disorder (MDD). All three were initially treated with TMS and psychotherapy because of the reduced risk of side effects. Two patients failed to respond adequately to treatment and were switched to ECT. The third patient displayed an adequate response to TMS but failed to maintain the improvement. This patient had to receive ECT in the post-partum period due to on-going depressive symptoms. Subsequently this patient responded adequately to ECT. Further studies of novel, non-pharmacological treatment methods for MDD during pregnancy (such as TMS and ECT) and detailed investigations of the factors associated with treatment responses in such patients are needed. Our cases demonstrate the need to evaluate the effectiveness of TMS in larger samples of pregnant patients diagnosed with MDD. http://pubs.sciepub.com/ajcmr/2/1/5/ajcmr-2-1-5.pdf electroconvulsive treatmentmajor depressive disorderpregnancytranscranial magnetic stimulation