Perioperative Adjunctive Esketamine for Postpartum Depression Among Women Undergoing Elective Cesarean Delivery
JAMA Network Open March 6, 2024 Yu Chen, Yu Guo, Han Wu et al. 63 citations
A single intravenous dose of esketamine given during cesarean delivery, followed by 48 hours of patient-controlled analgesia containing esketamine, reduced early postpartum depression symptoms. On day 7 after delivery, 23% of women who received esketamine screened positive for postpartum depression (score of 10 or higher on the Edinburgh Postnatal Depression Scale) compared with 35% in the placebo group. The difference in depression scores between groups was small but statistically significant. However, by days 14, 28, and 42, there were no differences between groups in depression screening rates or score changes. Pain scores were similar between groups except for a small advantage with esketamine during movement at 72 hours. The antidepressive effect may not apply to women with low baseline depression scores.