Ketamine acts as a rapid and long-lasting antidepressant, but its molecular mechanisms are unclear. In mice subjected to chronic social stress, microRNA miR-98-5p was downregulated in the prefrontal cortex and hippocampus. Overexpressing miR-98-5p with an agonist alleviated depression-like behaviors. Ketamine administration upregulated miR-98-5p, and inhibiting it with an antagonist blocked ketamine's antidepressant effect. This suggests a novel molecular mechanism for ketamine's action and that targeting miR-98-5p could be beneficial for depression treatment.
A meta-analysis of 13 studies with 2,716 patients found that perioperative esketamine lowers the risk of postpartum depression and reduces Edinburgh Postnatal Depression Scale scores at 1 and 6 weeks after cesarean section, and decreases pain scores within 48 hours during movement and 24 hours at rest. However, esketamine increases adverse effects such as hallucinations, dizziness, blurred vision, and diplopia. Prenatal body mass index is inversely correlated with mood response to esketamine one week after surgery. The studies had clinical heterogeneity, used different EPDS thresholds for diagnosing postpartum depression, and lacked racial diversity.