This meta-analysis (2022) explores the use of ketamine (35mg/70kg) in offsetting postpartum depression (PPD). It was found that the score and the prevalence of PPD within 1 week postpartum were significantly reduced, whereas the PPD score after 4 weeks postpartum showed no superiority.

Abstract

“The feasibility of intravenous ketamine administration during the perioperative period of cesarean section to prevent postpartum depression (PPD) has not been determined by meta-analysis. To evaluate the efficacy, safety and dose of prophylactic ketamine in offsetting PPD, we retrieved the following databases in English or Chinese from inception to December 2020: Pubmed, Embase, Web of Science, The Cochrane Library, CNKI, VIP and Wanfang. A total of 10 studies (9 RCTs and 1 retrospective study) were included with 2087 cases. Meta-analysis showed that in the ketamine group, the score and the prevalence of PPD within 1 week postpartum were significantly reduced, whereas PPD score after 4 weeks postpartum showed no superiority. There was no significant difference in terms of total adverse events rate, although vomiting occurred more frequently in the ketamine group. In addition, we found that ketamine efficacy emerged at 0.5 mg/kg. By meta-regression, we observed that: (1) Age and BMI are negatively associated with mood response to ketamine. (2) An analgesic pump containing ketamine for continuous 48 h postpartum administration was more efficacious than an intravenous injection of ketamine during cesarean section. Current evidence shows ketamine could be efficacious and safe in the prophylactic management of PPD in women having a cesarean section.”

Authors: Qiuwen Li, Saiying Wang & Xi Mei

Summary of A single intravenous administration of a sub-anesthetic ketamine dose during the perioperative period of cesarean section for preventing postpartum depression: A meta-analysis

Introduction

Ketamine is a glutamatergic N-methyl-d-aspartate (NMDA) receptor antagonist that has been shown to be effective for major depressive disorder and treatment resistant depression, especially when suicidal ideation is present. Its diverse effects make it distinctive from traditional antidepressants.

Material and methods

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A single intravenous administration of a sub-anesthetic ketamine dose during the perioperative period of cesarean section for preventing postpartum depression: A meta-analysis

https://doi.org/10.1016/j.psychres.2022.114396

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Study details

Compounds studied
Ketamine

Topics studied
Depression Postpartum Depression

Study characteristics
Meta-Analysis Literature Review