Ketamine injections after giving birth reduce risk of postpartum depression

For the study, researchers surveyed 361 mothers with a median age of 32 years and no history of depression. Researchers collected data from June 2020 to August 2022.

The researchers concluded that administering a single low dose of esketamine immediately after birth to people with symptoms of prenatal depression reduced the risk of a major depressive episode by about 75% at day 42.

Participants were divided into two groups: one was given esketamine and the other was given a placebo injection 40 minutes after giving birth.

Participants were interviewed 18 to 30 hours after giving birth, then again on day 7, and again on day 42.

The researchers found that after 42 days, only 6.7% of mothers given esketamine experienced a major depressive episode, compared to 25.4% of mothers who received a placebo injection.

Pregnancy involves many physical, psychological, and hormonal changes.

“After giving birth, many women experience overwhelming emotions and sadness, known as “.baby blues,' Said Dr. Kimia Porezaei, Director of Northwell Lenox Hill Mental Health Outpatient Center. Poleszaei was not involved in the research. “these [initial] Emotions are usually short-lived, lasting only two weeks at most. ”

However, after the “baby blues” subsided, 1 in 7 women may develop postpartum depressionusually appears within the first 6 weeks of pregnancy.

“It is important to note that symptoms of depression and anxiety can appear during any trimester of pregnancy. Postpartum depression occurs when the adolescent mother has a history of depression or postpartum depression in her family “It's more common in women with limited social support,” said Pourzej.

“The prevalence of postpartum depression varies between reports and definitions, but most sources believe the prevalence is between 9 and 15 percent.” Dr. Sina Nikain, a psychiatrist in charge of interventional psychiatry services at Yale New Haven Hospital. Nikain was not involved in the study.

“Onset can occur either before or after birth, with almost 50% of cases occurring postpartum. When onset occurs postpartum, it most commonly begins during the first few months after birth.”

Most authorities agree that the symptoms are similar to major depressive disorder (MDD), with little difference, Nikain explained.

Symptoms of postpartum depression include:

• Discomfort (depressed mood)
• Anhedonia (decreased interest or pleasure)
• Changes in weight and/or appetite
• changes in sleep
• Malaise
• Feeling tired or fatigued
• feeling of worthlessness
• decreased concentration
• psychomotor arousal
• thoughts about death, suicidal thoughts

There are two forms of ketamine treatment available.

The first and most common treatment is esketamine (Supravat), a nasal spray approved by the FDA as a treatment-resistant product. symptoms of depression And the same goes for depression in relation to suicide risk.

Esketamine is started at a dose of 56 mg twice weekly. The dose is usually increased to 84 mg at the end of the first month. Dosing frequency will decrease over time, but Dr. John Crystalprofessor of psychiatry and medical pioneer at Yale University School of Medicine ketamine therapy It was explained that this is a case of depression. Crystal was not involved in this research.

In the United States, ketamine infusion therapy most commonly involves infusions of R,S-ketamine (a mixture of two mirror image molecules (isomers): R-ketamine and S-ketamine (esketamine)) at a dose of 0.5 mg/dose. is. kg intravenously over 40 minutes.

“It should be noted that a recently published clinical trial involved intravenous administration of S-ketamine at a dose of 0.2 mg/kg,” Crystal said.

“The S-isomer of ketamine is more potent than the R-isomer, so a lower dose was used. Therefore, this S-ketamine dose is a 0.5 mg/kg dose of R,S-ketamine (0.25 mg R,S-ketamine infusion frequency is similar to esketamine.”

Neither R,S-ketamine nor esketamine is approved by the FDA to treat postpartum depression. The dosage and frequency of his R, S-ketamine and his S-ketamine for postpartum depression have not yet been established.

about 1 out of 3 People with depression do not respond to conventional treatments. First-line interventions include SSRI drugs, which take several weeks to take effect.

“One of the benefits of esketamine (and ketamine) is its rapid onset of action, which may be beneficial for people suffering from severe depression and suicidality,” Pourrezaei said. Masu. “When considering esketamine, it is important to determine whether the benefits of treatment outweigh the risks.”

Esketamine is considered relatively safe and well-tolerated when administered under medical supervision.

“Patients are carefully screened to determine risk before treatment, vital signs are closely monitored, and doctors can address common side effects or initiate appropriate protocols in the event of a rare emergency.” “We are ready to do that,” Pourrezaei said.

most common harmful effects Ketamine includes:

There are many other treatments available besides ketamine therapy. antidepressants (Also used for major depressive disorder) Often used for postpartum depression.

“Brexanolone and Zuranoron Both are specifically approved for postpartum depression,” Nikain said. “Another option is therapy, but it should always be considered alone or in combination with other treatments.”

It is also important to note that treatment is not a one-size-fits-all approach.

“Every treatment comes with some degree of risk and side effects,” Nikain says. “Therefore, treatment decisions should be individualized, based on close collaboration between professionals and patients, to ensure the best outcome.”

A new study shows that a single low-dose injection of esketamine immediately after birth reduces major depressive episodes in patients with prenatal depression.

It is important to weigh the benefits and risks before using esketamine to treat postpartum depression.

There are other alternatives, such as antidepressants, that can help treat postpartum depression.