Postpartum Esketamine lowers major depressive episodes in new mothers at 42 days

Intravenous administration of Esketamine (0.2 mg per kg) immediately after giving birth considerably reduced the incidence of major depressive episodes at 42 days postpartum by nearly 3 quarters, a clinical trial published in BMJ (Clinical Research Education) elucidated.

The study, which involved 364 participants (mean age 31.8 years) across multiple tertiary care hospitals, found that mothers who received Esketamine experienced a 74% reduction in the prevalence of major depressive episodes (6.7% {12 out of 180 patients}) compared to those who received a placebo (25.4% {46 out of 181 patients}) with P<0.001 at 42nd day of childbirth.

The trial, designed as a randomized, double-blind, placebo-controlled study, also evaluated outcomes including scores on the Edinburgh postnatal depression scale and the Hamilton depression rating scale (range 0 to 52; with increased scores displaying worse depression). Results consistently favoured the Esketamine group at both seven and 42 days postpartum (P<0.001 for all comparisons), indicating significant improvements in depressive symptoms.

While the Esketamine group did report a higher incidence of transient neuropsychiatric adverse events than the control group (45.1% versus 22.0%; P<0.001), these symptoms were mild and resolved spontaneously in a day, demanding no specific pharmacological therapies for the same.

Additional examination is necessary to confirm these outcomes and to better understand the long-term effects and safety of Esketamine in this population, concluded the study authors.