By the Policy Center for Maternal Mental Health

New study shows single intravenous infusion of Esketamine in the postpartum period reduces postpartum depression in mothers who had prenatal depression

A new study shows that a low-dose injection of eskatamine given after childbirth reduces major depressive episodes in those with depression during pregnancy by about 75% at 42 days postpartum. Low-dose ketamine or esketamine has previously been shown to reduce depression in mothers having a cesarean delivery but mothers with depression during pregnancy were excluded from the study.

Researchers found that participants with prenatal depression who received the eskatamine infusion post-childbirth had lower Edinburgh Postnatal Depression Scale (EPDS) scores at 7 and 42 days postpartum as well as lower Hamilton depression scores at 42 days postpartum than participants who received a placebo infusion.

Additionally, participants who received the eskatamine intravenous infusion experienced minimal side effects. While the esketamine group reported more sedation and had some dizziness and other mild neuropsychiatric symptoms, most of these side effects lasted less than a day and did not require additional treatments. Blood pressure, heart rate, and oxygen saturation were similar between eskatamine and placebo groups.

As depression during pregnancy increases the risk for postpartum depression, this new research presents promising ways to reduce and prevent postpartum depression in mothers experiencing prenatal depression. As most of the participants had mild prenatal depression and mothers with preexisting psychiatric conditions were excluded from this study, future studies should investigate the effectiveness of eskatamine on this excluded group of women, as well as women with more severe prenatal depression. Researchers conclude that low-dose esketamine should be considered in mothers with symptoms of prenatal depression.

Esketamine is a more potent version of ketamine, an anesthetic that has also been used to treat depression. Recently, esketamine earned FDA approval specifically for use as a nasal spray to treat patients with treatment-resistant depression. A preliminary review shows that most insurers cover esketamine nasal spray with a diagnosis of depression combined with a documented history of treatment-resistant depression.