The Pharmacokinetics of Ketamine in the Breast Milk of Lactating Women: Quantification of ketamine and metabolites
Philip E. Wolfson, Rob Cole, Kara L. Lynch, Cassandra Yun, Jason Wallach, Julane Andries, Melissa Whippo
February 13, 2021 DOI: 10.22541/au.161325028.80476344/v1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Longitudinal pharmacokinetic analysis |
|---|---|
| Sample size | 4 |
| Population | Lactating women receiving intramuscular ketamine |
| Intervention | Ketamine |
| Dose | 0.5 mg/kg and 1.0 mg/kg intramuscular |
| Topics | Esketamine Ketamine |
| Citations | 5 |
| Key findings | Ketamine and its metabolites were measured in breastmilk from 4 women after intramuscular doses of 0.5 mg/kg and 1.0 mg/kg. The authors report that ketamine's presence in breastmilk was negligible after a 12-hour suspension period, and they argue this supports the safety of intermittent ketamine treatment for postpartum depression and other emotional disorders during breastfeeding without significant interruption or infant exposure. |
Abstract
Abstract: There is no available data on the secretion and concentration of ketamine and its metabolites in breastmilk. There are statements in the literature made as to the safety of the use of ketamine in lactating women, though these are unsupported. This information is pertinent for the treatment of breastfeeding women who may have depression, PTSD, postpartum depression, and other emotional difficulties and would benefit from ketamine treatment. The objective of this study was to measure the presence and concentration of ketamine in breastmilk and three of its metabolites. We have provided a longitudinal pharmacokinetic analysis of the presence of ketamine and several of its major metabolites (norketamne, dehydronorketamine and hydronorketamine) in 4 women receiving 2 different intramuscular doses of ketamine—0.5mg/kg and 1.0mg/kg. Our results demonstrate the insignificance of ketamine’s presence In breast milk after a 12-hour period of suspension. Given ketamine’s proven record of effectiveness for the treatment of depression, and its intermittent use for this purpose, our data support the safety of its administration for the treatment of postpartum depression (PPD)and other emotional disorders during a woman’s chosen period to provide breast milk to her child without significant interruption or exposure. This provides the necessary data for the study of ketamine assisted psychotherapy as a potential treatment of postpartum emotional disorders without the loss of the relationship between mother and child which breast feeding so vitally provides. We review conventional pharmacologic treatments involved in the treatment of PPD.
Comparable studies
Other experimental studies on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Ketamine activates psychosis and alters limbic blood flow in schizophrenia Schizophrenic individuals | 1995 | Experimental study | |
| The spectral exponent of the resting EEG indexes the presence of consciousness during unresponsiveness induced by propofol, xenon, and ketamine Healthy participants | 2019 | Controlled experimental study | n = 15 |
| Ketamine Increases Human Motor Cortex Excitability to Transcranial Magnetic Stimulation Normal human subjects | 2003 | Experimental study | n = 7 |
| Evidence that Subanesthetic Doses of Ketamine Cause Sustained Disruptions of NMDA and AMPA-Mediated Frontoparietal Connectivity in Humans Human participants | 2015 | Experimental study | |
| Simultaneous population pharmacokinetic modelling of ketamine and three major metabolites in patients with treatment‐resistant bipolar depression Patients with treatment-resistant bipolar depression | 2012 | Population pharmacokinetic analysis | n = 9 |