The effect of ketamine on preventing postpartum depression

Abstract

Postpartum depression is a common disabling psychosocial disorder that could have adverse effects on the life of the mother, infant, and family. The present study was conducted to evaluate the effect of ketamine on preventing postpartum depression in women undergoing caesarian sections considering the relatively known positive effect of ketamine on major depression. The present double-blind, randomized clinical trial was conducted on 134 women undergoing scheduled caesarian sections. Participants were randomly allocated into two groups of control and intervention. To induce anesthesia, 1–2 mg/kg of body weight of Nesdonal and 0.5 mg/kg of body weight of ketamine were used in the intervention group, while only 3–5 mg/kg of body weight Nesdonal was administered in the control group. Data were gathered using the Edinburgh Postnatal Depression Scale (EPDS) in three stages: before the caesarian section and two and four weeks after the caesarian section. Data were analyzed using variance analysis with repeated measures and the Chi-square test. Results of the present study showed that the mean (± standard deviation) of the depression score in the intervention and control groups were 13.78±3.87 and 13.79±4.78(p = 0.98) before the caesarian section, 11.82±3.41 and 14.34±4.29 (p < 0.001) two weeks after and 10.84±3.48 and 13.09±3.79 (p = 0.001) four weeks after the caesarian section, respectively. Using ketamine in the induction of general anesthesia could be effective in preventing postpartum depression. However, further studies are required to strengthen these findings.

The Pharmacology and Clinical Applications of Psychedelic Medicines Within Midwifery Practice

“…At 4 weeks postoperatively, the control group had a decrease in EPDS score to a mean of 13.09, which was a significant difference from the 2‐week postoperative mark, but not from the original EPDS mean scores. The intervention group had a decreased to a mean score of 10.84, which was significantly different from the preoperative scores, but not significantly different compared with the 2‐week scores for that group 45 . Essentially, although both groups showed significant improvements in depression scores at various times, the trending decrease happened at different points, warranting further study to examine why.…”

“…Women received either 1 to 2 mg/kg of sodium thiopental and 0.5 mg/kg of ketamine or just 3 to 5 mg/kg of sodium thiopental to induce anesthesia for their scheduled cesareans. 45 Depression scores between the intervention and control groups were not significantly different preoperatively. At 2 weeks postoperatively, the control group had an increase in the mean EPDS score to 14.34, although it was not significant, whereas the intervention group showed a significant decrease in the mean EPDS scores to 11.82 using a P value less than 0.001.…”

A novel mouse model of postpartum depression and the neurobiological effects of fast-acting antidepressant treatments

“…Currently, there is no effective treatment to achieve the complete symptomatology remission of all PPD patients. Even though exogenous allopregnanolone (Brexanolone, Zulresso) has been recently approved as a unique treatment for PPD by the Food Drug Administration 19,20 and ketamine has been used as a prophylactic treatment after caesarean sections 22,58 , the exact mechanism of action of both drugs remains barely speculative. Here we demonstrated that low doses of ketamine reverse the depressive-and anhedonia-like behaviour induced by MSEW, as previously shown in other animal models of depression 59,60 .…”

“…Alternatively, ketamine has also been suggested as promising drug for preventing PPD in women who undergo caesarian sections 22 . Ketamine is a glutamate N-methyl-d-aspartate (NMDA) non-competitive receptor antagonist that shows rapid antidepressant effects 23 .…”

Ketamine as a prophylactic resilience-enhancing agent

“…A similar study by Alipoor et al ( 30 ) was conducted on 134 women undergoing c-section randomized to either ketamine (0.5 mg/kg) plus nesdonal (1–2 mg/kg) or nesdonal (3–5 mg/kg) alone administered intravenously during the induction phase of anesthesia. Participants were assessed with the EPDS at 2 and 4 weeks postpartum.…”