Palabras clave
Escetamina
Depresión posparto
Cómo citar
Copyright © | Todos los derechos reservados.
La revista posee los derechos de autor exclusivos para la publicación de este artículo en los términos de la ley brasileña 9610/98.
Reproducción parcial
El uso de partes de los textos, figuras y cuestionario del artículo es libre, siendo obligatoria la citación de los autores y revista.
Reproducción total
Está expresamente prohibido y debe ser autorizado por la revista.
Resumen
Objetivo: Analizar el uso de la ketamina y su derivado, la escetamina, en la prevención de la depresión posparto. Métodos: Revisión integrativa de la literatura, realizada de acuerdo con las recomendaciones PRISMA y orientada por la estrategia PICO. La búsqueda se llevó a cabo en las bases de datos PubMed, SciELO y Biblioteca Virtual en Salud. Se aplicaron como filtros el período de publicación entre 2021 y 2025 y el diseño de ensayo clínico aleatorizado (ECA). Resultados: Se incluyeron trece ECAs que evaluaron diferentes esquemas de administración de ketamina o escetamina, predominantemente en el contexto perioperatorio de cesáreas, con énfasis en la prevención de la depresión posparto. Se observó una concentración geográfica de los estudios, realizados mayoritariamente en China, así como heterogeneidad en cuanto a las dosis, las vías de administración, el momento de aplicación y los instrumentos utilizados para la evaluación de los desenlaces depresivos. Consideraciones finales: El análisis de los ECAs indica que la ketamina y la escetamina han sido investigadas como estrategias farmacológicas prometedoras para la prevención de la depresión posparto, especialmente en el contexto perioperatorio. No obstante, se evidencia la necesidad de investigaciones adicionales, realizadas en diferentes escenarios y con protocolos estandarizados, para definir mejor la eficacia, la seguridad y el papel de estas sustancias en la promoción de la salud mental materna durante el período perinatal.
Referencias
ALBUQUERQUE RN, LEITE MGS. Fatores associados à depressão gestacional: uma Revisão integrativa. Revista Saúde Multidisciplinar, 2023; 14(1): 3-9.
ALIPOOR M, et al. The effect of ketamine on preventing postpartum depression. Journalof Medicineand Life, 2021; 14(1): 87-92.
APA – Associação Americana de Psiquiatria. Manual diagnóstico e estatístico de transtornos mentais: DSM-5-TR. 5. ed. rev. Porto Alegre: Artmed, 2023; 1152p.
BOERMA T, et al. Global epidemiology of use of and disparities in caesarean sections. The Lancet, 2018; 392(10155): 1341-1348.
CAMPOS CA, et al. Fatores de risco, proteção, diagnóstico e tratamento da depressão pós-parto no contexto da atenção primária. Revista Eletrônica Acervo Saúde, 2021; 13(1): e5410.
CASTRO ACP, et al. Avaliação da depressão no puerpério imediato e tardio. Revista Eletrônica Acervo Saúde, 2024; 24(12), e18741.
CHEN Y, et al. Perioperative adjunctive esketamine for postpartum depression among women undergoing elective cesarean delivery: a randomized clinical trial. JAMA Network Open, 2024; 7(3): e240953.
CHEN J, ZHAO N. Recent advances in drug development and regulatory science in China. Therapeutic Innovation & Regulatory Science, 2018; 52(6): 739-750.
DENNIS C-L, DOWSWELL T. Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database of Systematic Reviews, 2013; 2: 1-161.
DI VINCENZO JD, et al. The effectiveness, safety and tolerability of ketamine for depression in adolescents and older adults: A systematic review. Journal of Psychiatric Research, 2021; 137: 232-241.
FDA – Food & Drug Administration. FDA warns patients and health care providers about potential risks associated with compounded ketamine products, including oral formulations, for the treatment of psychiatric disorders. FDA, 10 out. 2023. Disponível em: https://www.fda.gov/drugs/human-drug-compounding/fda-warns-patients-and-health-care-providers-about-potential-risks-associated-compounded-ketamine. Acessoem: 28 dez. 2025.
GUAN L-N, et al. Research progress in the treatment of postpartum depression. Cellular and Molecular Neurobiology, 2025; 45(1): 1-12.
HAN Y, et al. S-ketamine as an adjuvant in patient-controlled intravenous analgesia for preventing postpartum depression: a randomized controlled trial. BMC Anesthesiology, 2022; 22(1): 1-7.
JAWAD MY, et al. The efficacy and safety of adjunctive intranasal esketamine treatment in major depressive disorder: a systematic review and meta-analysis. Expert Opinion on Drug Safety, 2022; 21(6): 841-852.
LI S, et al. Effects of ketamine and esketamine on preventing postpartum depression after cesarean delivery: A meta-analysis. Journal of Affective Disorders, 2024a; 351: 720-728.
LI S, et al. Efficacy of esketamine for the treatment of postpartum depression and pain control following cesarean section: a randomized, double-blind, controlled clinical trial. BMC Anesthesiology, 2024b; 24(1): 1-10.
LING B, et al. Effect of single intravenous injection of esketamine on postpartum depression after labor analgesia and potential mechanisms: a randomized, double-blinded controlled trial. BMC Pharmacology and Toxicology, 2023; 24(1): 1-8.
LIU Q-R, et al. Effects of perioperative use of esketamine on postpartum depression risk in patients undergoing cesarean section: a randomized controlled trial. Journal of Affective Disorders, 2023; 339: 815-822.
LUO M, et al. Effects of esketamine on post-partum depression in patients with different personality types undergoing caesarean section: randomised controlled trial. ActasEspañolas de Psiquiatría, 2025; 53(4): 766-777.
MARTINS FM, et al. Fatores desencadeantes e sintomas associados à depressão pós-parto. BrazilianJournalofImplantologyand Health Sciences, 2024; 6(2): 222-242.
MOSOLOVA D. Pharmaceutical companies turn to jurisdictions with simpler regulatory regimes. Financial Times, 21 out. 2024. Disponível em: https://www.ft.com/content/3d861acb-8e7d-4157-b845-81124254da8a. Acessoem: 28 dez. 2025.
O'HARA MW, MCCABE JE. Postpartum depression: current status and future directions. Annual Review of Clinical Psychology, 2013; 9(1): 379-407.
REN L, et al. Intraoperative esketamine and postpartum depression among women with cesarean delivery: a randomized clinical trial. JAMA Network Open, 2025; 8(2): e2459331.
SHANG Y, et al. The effect of low-dose esketamine on maternal depression after cesarean delivery. Journal of Psychosomatic Obstetrics &Gynecology, 2025; 46(1): 2527659.
SHEN J, et al. The effect of low-dose esketamine on pain and post-partum depression after cesarean section: a prospective, randomized, double-blind clinical trial. Frontiers in Psychiatry, 2023; 13: 1038379.
TAN R, et al. Current landscape of innovative drug development and regulatory support in China. Signal Transduction and Targeted Therapy, 2025; 10(1): 1-36.
TRICCO AC, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Annals of Internal Medicine. 2018; 169(7): 467-473.
WAN X, et al. The effect of a subclinical dose of esketamine on depression and pain after cesarean section: A prospective, randomized, double-blinded controlled trial. Medicine, 2024; 103(44): e40295.
WANG S-M, et al. Rapid onset of intranasal esketamine in patients with treatment resistant depression and major depression with suicide ideation: a meta-analysis. Clinical Psychopharmacology and Neuroscience, 2021; 19(2): 341.
WANG S, et al. Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial. BMJ, 2024; 385: e078218.
WANG W, et al. Effects of esketamine on analgesia and postpartum depression after cesarean section: a randomized, double-blinded controlled trial. Medicine, 2022; 101(47): e32010.
WANG W, et al. Effect of pre-administration of esketamine intraoperatively on postpartum depression after cesarean section: a randomized, double-blinded controlled trial. Medicine, 2023; 102(9): e33086.
WHO – World Health Organization. ICD-11 - International Classification of Diseases 11th Revision. Disponível em: https://icd.who.int/en. Acesso em: 26 dez. 2025.
XU L-L, et al. RETRACTED: Efficacy and safety of esketamine for supplemental analgesia during elective cesarean delivery: a randomized clinical trial. JAMA Network Open, 2023; 6(4): e239321.
XU S, et al. Esketamine pretreatment during cesarean section reduced the incidence of postpartum depression: a randomized controlled trail. BMC Anesthesiology, 2024; 24(1): 1-10.