How Does Ketamine Treat Postpartum Depression?

How Does Ketamine Treat Postpartum Depression?

Having the baby blues after childbirth – mood swings, minor sleeping and eating problems, for instance – is common in many women, but the symptoms often go away quickly on their own. But symptoms that linger and get worse could be signs of a more serious illness called postpartum depression, which may affect 10% of all women who give birth.

What is Ketamine?

Ketamine is a medicine that was synthesized in the early 1960s as an alternative to sedatives widely available at that time. During early research, ketamine was discovered to have psychoactive properties, and the label “dissociative medicine” was coined on its behalf. But its first widespread use was as a pre- and post-surgical anesthetic, and it gained widespread acceptance after being field-tested on wounded U.S. combat troops fighting in Vietnam. Soon afterward, people stumbled onto ketamine’s ability to reduce symptoms of many physical and psychological problems, including chronic pain and postpartum depression.

Ketamine for Postpartum Depression

Ketamine has a long history of being used to treat symptoms of physical pain and depression, but how it works was always an educated guess. Early on, its value as a post-operative sedative was well known. Then its recreational use made people think of its psychoactive properties – making someone feel outside of their body and detached from reality – could be used for posttraumatic stress disorder, postpartum depression, anxiety, and other mental ailments.

But the mechanics were still a mystery. What doctors and scientists knew, however, was that most antidepressants worked to boost activity within a class of neurotransmitters – chemical messengers within the brain – including serotonin, norepinephrine, and dopamine. Results were mixed, with some people achieving lasting positive effects, while others continued grappling with treatment-resistant depression and other mental illnesses.

In the 1990s, John Krystal, M.D., Ph.D., and Dennis Charney, M.D., at Yale University, decided to make a leap of faith and focus on ketamine and its effects on another neurotransmitter, glutamate. Glutamate is the brain’s primary excitatory neurotransmitter, “responsible for activating neurons to turn on the key circuits that drive all forms of behavior.” Krystal, Charney, and their research colleagues eventually discovered that low doses of ketamine, much lower than what had induced psychosis-like symptoms in previous cases, significantly reduced depressive-like symptoms within a matter of hours.

IV Ketamine Treatment and Postpartum Depression

While ketamine has been used to reduce depression symptoms for decades, a generic version was approved by the United States Food and Drug Administration in 2019 specifically to fight treatment-resistant depression. Today, researchers have begun looking into it for women who experience postpartum depression. In fact, Massachusetts General Hospital and the United States National Institutes of Health (NIH) both cite research that took place in China in 2016. Chinese researchers discovered that ketamine not only relieved depression as expected, but also acted as a preventative for expectant mothers at risk of postpartum depression.

Risk factors that made certain women ideal candidates for study by researchers included:

  • Women who experience prenatal depression, or depression during pregnancy. This may be the strongest predictor for future instances of postpartum depression.
  • Women who experience anxiety during pregnancy.
  • Women who have a history of depression prior to conception may be at greater risk of getting postpartum depression.
  • Women who experience the baby blues, whose symptoms are severe and continually linger.
  • The experience of stressful life events and poor social support networks
  • Marital problems or general dissatisfaction in their relationship with their partner. This is another key indicator of future postpartum depression.
  • Poor self-esteem.
  • Childcare issues.
  • Having an infant with a stressful temperament.

Ketamine as a Preventative

Another report by the NIH National Library of Medicine talked about depression in high-risk women who were scheduled to undergo delivery by cesarean section. It noted that a single dose of ketamine during the delivery could act as a preventative for postpartum depression. In this case, researchers advocated for further studies.

Diagnosis & Treatment

Following childbirth, women often see their healthcare provider for regular follow-up appointments, and this is the ideal time to talk about anxiety, mood swings, and more worrisome indicators of postpartum depression they may be experiencing. To be diagnosed, depression symptoms must last for at least two weeks and include depressed moods, lack of interest in enjoyable things, changes in weight, sleeping problems, and psychomotor agitation (pacing, talking fast, and other symptoms).

Treatment often includes psychotherapy and antidepressants. Healthcare providers may also recommend diet and lifestyle changes, self-help strategies, or ketamine therapy from specialty clinics.

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