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.
Military Medical Research
July 23, 2024
Hai-Lou Zhang, Yan Sun, Zhang-Jie Wu et al.
24 citations
The neuropeptide PACAP in the hippocampal dentate gyrus (DG) mediates rapid antidepressant responses. Chronic paroxetine increased hippocampal PACAP, and blocking PACAP in the DG slowed the antidepressant effect. PACAP levels were reduced in two depression models, and knocking down PACAP in the DG caused depression-like behaviors. A single infusion of PACAP into the DG produced a rapid and sustained antidepressant effect in normal and stressed mice. Optogenetic excitation of PACAP-expressing neurons instantly elicited antidepressant responses, while inhibition induced depression-like behaviors. PACAP infusion inhibited CaMKII-eEF2 signaling and activated mTOR-BDNF signaling. Acute ketamine increased PACAP, and blocking PACAP attenuated ketamine's rapid antidepressant effect.
Annals of general psychiatry
May 8, 2024
Xiao-Fen Fan, Ju-Yi Peng, Li Zhang et al.
13 citations
Adolescents with depression who self-harm often rely on negative coping strategies and may benefit from positive alternatives. A combination of mindfulness therapy and mentalization-based family therapy (MBFT) was tested against MBFT alone in 80 hospitalized adolescents with depressive disorder and suicidal ideation, randomly assigned to two groups of 40. After intervention, both groups showed lower scores on psychological health and suicidal ideation scales, but the group receiving both therapies had significantly greater improvements. The findings suggest that adding mindfulness therapy to MBFT can improve psychological condition and reduce suicidal thoughts in this population, supporting its clinical use.
Journal of affective disorders
May 1, 2025
Xiaohui Zhou, Li Zhang, Weiwei Gao et al.
4 citations
In a rat model of depression, modified electroconvulsive therapy (MECT) effectively reduced depressive symptoms but worsened cognitive impairments, increased hippocampal neuronal death, and triggered neuroinflammation. Adding esketamine, an FDA-approved antidepressant, reversed those cognitive deficits, reduced cell death and inflammation, and improved synaptic plasticity. Esketamine worked by increasing levels of the protein KLF4, which in turn blocked the p38 MAPK signaling pathway. When KLF4 was experimentally reduced, esketamine's protective effects disappeared, confirming its essential role. The findings suggest that combining esketamine with electroconvulsive therapy could protect against memory and thinking problems in patients.
Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae
August 1, 2024
Li Zhang, Jiao He, Cheng-Hui Pi et al.
1 citation
New daily persistent headache (NDPH) is a rare primary headache with a sudden, precisely dated onset that is difficult to treat and can cause disability. The exact cause remains unknown. A case is reported of a patient with refractory NDPH who was treated with intravenous esketamine at a sub-anesthetic dose.
PloS one
January 1, 2026
Yijun Wang, Xiaolu Lin, Xiang Zou et al.
After cesarean section, intravenous esketamine added to standard pain control reduced maximum pain scores within the first 24 hours (median 5 vs. 6 on a 0-10 scale) and also lessened pain at rest, with movement, and visceral pain at all measured time points. Women receiving esketamine had lower rates of postoperative depression, anxiety, and sleep disorders, as well as lower levels of the inflammatory marker C-reactive protein. The time before the first patient-controlled painkiller press was longer in the esketamine group. No significant differences were seen in hyperalgesia or side effects between groups.