A single-site randomized clinical trial at a Chinese hospital found that administering a low dose of esketamine during cesarean delivery significantly reduced the incidence of postpartum depression at six weeks. Among 308 women, 10.4% who received esketamine developed postpartum depression compared with 19.5% who received a placebo saline infusion, a relative risk of 0.53. The authors suggest esketamine shows promise for preventing postpartum depression in this setting but call for further research in broader clinical practice.
Electroconvulsive therapy (ECT) effectively treats depression but impairs learning and memory. Ketamine may reduce these cognitive side effects. Using a rat model of depression, researchers tested whether esketamine (a ketamine derivative) protects memory after electroconvulsive shock (ECS), the animal analogue of ECT. A low dose of esketamine increased the expression of metabotropic glutamate receptor 5 (mGluR5) and NMDA receptor 1 in the hippocampus, reduced ECS-induced memory impairment, and improved depressive-like behavior. Blocking mGluR5 with the antagonist MTEP reversed these effects. The findings suggest esketamine protects spatial learning and memory after ECS by upregulating mGluR5 and enhancing NMDA receptor activation.