An innovative study published in the British Medical Journal demonstrates a surprising advance in treating postpartum depression in new mothers. Researchers discovered that administering a single small dosage of esketamine right after labor significantly decreases the incidence of major depressive episodes in mothers with prenatal depression symptoms. This finding gives hope for addressing the mental health difficulties that many new mothers confront throughout the postpartum period.
The experiment is to determine whether a single low dose of esketamine, a ketamine-based medication, will help reduce postpartum depression in moms who experienced depressive symptoms during pregnancy. Postpartum depression is prevalent and has a harmful impact on both moms and infants. Esketamine is already used to treat depression, but its efficacy for postpartum depression has not been established in recent years.
The researchers did a randomized, double-blind, placebo-controlled experiment at five Chinese hospitals from June 2020 to August 2022. This implies that in order to collect objective data, neither the subjects nor the researchers knew who was given esketamine and who was given a placebo. The study's objective was to determine whether administering a single dose of esketamine to a mother who experienced prenatal depression might reduce postpartum depression after giving birth.
The study included 364 mothers who were at least 18 years old and had mild depressive symptoms during pregnancy but no history of depression before pregnancy. They were preparing to give birth in the hospital. These mothers were randomly assigned to receive either esketamine or a placebo after giving birth.
After childbirth, the mothers received either a 40-minute infusion of esketamine or a placebo through a vein. Neither the mothers nor the doctors knew which treatment they received. The effects of the treatment were assessed through interviews and depression scales at different time points after childbirth, up to 42 days. The researchers also monitored any adverse effects of the treatment.
According to the study, the probability that mothers will have severe depression 42 days after giving birth decreased significantly when a low dose of esketamine was given to them immediately following birth. Specifically, among those who received esketamine, only 6.7% experienced major depressive episodes, compared to 25.4% of those who received a placebo. This means that esketamine reduced the occurrence of postpartum depression by about three quarters, which is a significant decrease in depression rates.
Apart from examining the incidence of major depressive episodes, the researchers assessed the severity of depression symptoms using two scales: the Edinburgh Postnatal Depression Scale (EPDS) and the 17-item Hamilton Depression Rating Scale. They discovered that moms who got esketamine scored lower on these scales at both 7 and 42 days postpartum than those who received a placebo. This shows that esketamine not only reduced the risk of depression but also helped to reduce the intensity of depressive symptoms among new mothers.
Esketamine showed potential in treating depression; however, concerns arose regarding its safety. Participants who received esketamine reported more neuropsychiatric side effects, such as dizziness and double vision, than those who got a placebo. However, these symptoms were temporary and did not require medical intervention. Furthermore, the study discovered no significant difference in other vital signs such as blood pressure, heart rate, or oxygen saturation between the esketamine and placebo groups. This indicates that, while there were some adverse effects, they were manageable and not harmful.
In conclusion, the study demonstrates that administering a single low dosage of esketamine right after delivery may significantly reduce the risk of postpartum depression in mothers who experienced prenatal depression. Despite some concerns about side effects, such as acute neuropsychiatric problems, esketamine appears to be a promising treatment for depression in this sensitive population. However, more research is required to fully understand its long-term safety and effectiveness. However, the results suggest that esketamine could be used as an effective therapy for mothers suffering from prenatal depression in order to prevent postpartum depression.
Reference:
1. Wang S, Deng CM, Zeng Y, Chen XZ, Li AY, Feng SW, et al. Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial. BMJ [Internet]. 2024 Apr 10 [cited 2024 Apr 12];385:e078218. Available from: https://www.bmj.com/content/385/bmj-2023-078218
(Input from various resources)
(Rehash/Susmita Bhandary/MSM)
