Research Review: 1 Single Low Dose of Esketamine after Childbirth Shows Promise for PPD
A single low dose of esketamine administered right after childbirth shows promise for postpartum depression, showing it could be a viable treatment option for new mothers showing signs of prenatal depression.
For many mothers, the joy of childbirth is coupled with the difficult challenge of perinatal depression. A new clinical trial offers hope that a single low dose of the drug esketamine, given shortly after delivery, could help prevent major depressive episodes in the postpartum period for mothers at high risk.
The randomized, placebo-controlled trial enrolled 364 pregnant women in China who screened positive for symptoms of prenatal depression. Either esketamine (0.2 mg/kg) or placebo was administered intravenously immediately after childbirth.
The results were highly promising:
At 42 days postpartum, only 6.7% of mothers who received esketamine had a diagnosed major depressive episode, compared to 25.4% in the placebo group.
Esketamine reduced the risk of postpartum depression by about 75%, with a number needed to treat of just 5 mothers.
Mothers given esketamine had significantly lower depression scores on the Edinburgh Postnatal Depression Scale and Hamilton Depression Rating Scale at both 7 days and 42 days after childbirth.
The antidepressant effects of the single esketamine dose appeared to last at least 6 weeks postpartum.
While some temporary side effects like dizziness, sedation and hallucinations occurred during and shortly after esketamine administration, these were short-lived and none required medical intervention.
The authors conclude that esketamine, by providing rapid and sustained antidepressant effects, could be a promising new treatment to prevent postpartum depression in high-risk mothers. However, they note that further research is still needed on optimal dosing and long-term effects.
This novel approach of administering esketamine immediately postpartum takes advantage of a critical window when mothers are already under close medical supervision. By quickly alleviating depressive symptoms in those predisposed, it could help improve maternal-infant bonding and child development outcomes.
While much more study is warranted, these findings suggest that a single dose of esketamine may be an effective, safe and convenient preventive strategy to protect the mental health of high-risk new mothers during the vulnerable postpartum period.
Read the full study here.