Ketamine for Postpartum Depression & Breastfeeding

Ketamine can be used in the treatment
for postpartum depression. A lot of the data is extrapolated from ketamine and
its use in treatment-resistant depression. The cool thing about ketamine
is that it works within hours to days for treatment-resistant depression and
for postpartum depression. This is critical because the relationship
between mother and child, especially early on, is very important for the child
and postpartum depression might even lead to suboptimal cognitive and
emotional development in the child, which later down the road might increase its
vulnerability to having depression and other psychiatric disorders. Compared to
standard treatment like SSRIs or antidepressants, those can take weeks to
months to kick in. But with ketamine, it can literally work within hours two days.
One of the other questions that we get about ketamine is its safety in
breastfeeding. So there aren’t a lot of studies that are examining ketamine and
its safety in breastfeeding. However, ketamine is actually used as a general
anesthetic agent during the delivery period, and the World Health Organization
states that when it’s used in that scenario, it’s safe for the mother to
breastfeed. But we’re using ketamine a bit differently when we’re using it for
depression because it requires multiple infusions. So to err on the side of
safety, we recommend that the mother “pumps” for two days prior to the infusion,
and then after the infusion, “pump and dump” to clear any ketamine and its
metabolites from the system. And then she can use the stored breast milk to feed
the baby. Please let me know if you have any questions, I’d be more than happy to
answer them, and thank you for joining me.

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