Effects of different doses of esketamine intervention on postpartum depressive symptoms in cesarean section women: A randomized, double-blind, controlled clinical study

• Published in: Journal of affective disorders 2023-10, Vol.339, p.333-341
• Main Authors: Yang, Si Qi, Zhou, Ying Yong, Yang, Shu Ting, Mao, Xiao Yuan, Chen, Liang, Bai, Zhi Hong, Ping, An Qi, Xu, Shou Yu, Li, Qiu Wen, Gao, Kai, Wang, Sai Ying, Duan, Kai Ming
• Format: Article
• Language: English
• Subjects: Esketamine; Postpartum depression; Postpartum depressive symptoms; Prenatal depression; Prophylactic interventions
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2023.07.007

The optimal dosage and method of esketamine for postpartum depressive symptoms (PDS) are unclear. We conducted a randomized controlled trial (RCT) to investigate the effect of different doses of esketamine on PDS in women undergoing cesarean section, with evidence of prenatal depression. The three groups were high- (2 mg kg−1) and low-dose (1 mg kg−1) esketamine via patient controlled intravenous analgesia (PCIA), following an initial intravenous infusion of 0.25 mg kg−1 esketamine, compared to placebo (0.9 % saline infusion). All groups also received the sufentanil (2.2 μg kg−1). The primary outcome was the incidence of PDS at 7 and 42 days postpartum. The secondary outcomes were: the remission from depression and total EPDS scores at 7 days and 42 days postpartum; mean change from baseline in the EPDS score; postoperative analgesia. i). 0.25 mg kg−1 of esketamine intravenous infusion combined with 1 mg kg−1 (n = 99) or 2 mg kg−1 (n = 99) esketamine PCIA reduces PDS incidence at 7 days postpartum (p