Merits and demerits of administering esketamine in preventing postpartum depression following cesarean section

Emergency cesarean section is associated with the development of postpartum depression. Esketamine has been demonstrated to have a rapid onset of antidepressant effects. Randomized controlled trials and meta-analyses have demonstrated the efficacy of esketamine in preventing postpartum depression after cessarean section. However, the data included in these analyses were derived from elective cesarean sections and differed in the dose and timing of esketamine administration. Esketamine is a dissociative anesthetic with a dose-dependent risk of inducing psychotic symptoms, including hallucinations. In the setting of cesarean section, esketamine should be administered with caution and only if the potential benefits outweigh the risks.