A single low dose injection of esketamine given right after childbirth can reduce the risk of major postpartum depression by about three quarters, finds a US study published in The BMJ. Up to 26 per cent of women suffer from depression during the perinatal period which is a strong predictor of postpartum depression.
Esketamine is made from a drug called ketamine which is used as an anaesthetic and to treat depression. To find out if a single low dose injection of esketamine given just after childbirth might reduce postpartum depression in mothers, the researchers enrolled 361 mothers, of an average age of 32 years, across five Chinese hospitals. The women did not have a medical history of depression, but had mild prenatal depression as indicated by a depression scale.
Participants were randomly assigned to receive either esketamine or placebo intravenously infused over 40 minutes after childbirth. They were interviewed 18 to 30 hours after childbirth and again at seven and 42 days. None of them took antidepressants or received psychotherapy during the follow-up period. Forty-two days after giving birth, 6.7 per cent of mothers given esketamine experienced a major depressive episode compared with 25.4 per cent of those given a placebo―a risk reduction of about 75 per cent.
Mothers treated with esketamine experienced more adverse events such as dizziness and double vision, but the symptoms lasted less than a day and did not require treatment. “Low dose esketamine should be considered in mothers with symptoms of prenatal depression,” the authors concluded.