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A ketamine derivative given to the mother after birth appears to reduce the risk of postpartum depression, suggests a study published Thursday in the British Medical Journal (BMJ), which however has important limitations.
The clinical trial, carried out in China, aims to prevent postpartum depression in mothers who have already suffered depressive symptoms during pregnancy, a form of so-called prenatal depression, which often continues after the baby is born.
A treatment that reduces depressive episodes
Gold, “In mothers with prenatal depression, a single low dose of esketamine, given shortly after delivery, reduced major depressive episodes (within) 42 days after birth by about three-quarters“, conclude the authors of the essay.
Esketamine, given here as an injection, serves as the basis of an anesthetic product. But its antidepressant properties have been the subject of research for several years. Some health authorities, such as the US Food and Drug Administration (FDA), have already approved it as an antidepressant.
This molecule is nevertheless the subject of controversy due to its lack of effectiveness against the most resistant depressions, as well as neuropsychological side effects such as speech difficulties or a feeling of dissociation.
An injection administered 40 minutes after delivery
Here, researchers assembled a group of several hundred mothers who experienced depressive symptoms during pregnancy.
Within 40 minutes of giving birth, half of them received an injection of esketamine, and the other half received a placebo.
Forty-two days later, less than 7% of the first group had recorded a major depressive episode, compared to a quarter of the second group.
Side effects have certainly been observed in large numbers, but they resolve on their own in less than a day.
If these results seem to support the effectiveness of esketamine in this indication, they must be put into perspective by several limitations of the study.
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Further work is needed to determine the effectiveness of esketamine
First, the researchers only included women whose depressive symptoms appeared during pregnancy. They excluded those who already had mental disorders before becoming pregnant.
Then, the women studied had rather mild prenatal depressive symptoms. It is therefore difficult to say whether esketamine is sufficient when prenatal depression is more severe.
Finally, and most importantly, the study ends a little more than a month after giving birth. We cannot therefore determine how long-lasting this injection protects against depression, or whether side effects may reappear after several weeks.