Ketamine and Depression Treatment: Proceed with Caution
Researchers from the University of Otago recently conducted an in-depth study on the escalating use of ketamine as a remedy for depression in New Zealand. The researchers expressed reservations about a swift, large-scale increase in the usage of this drug, despite acknowledging its beneficial aspects in treating depression resistant to established treatments. Some problems associated with its use include high relapse rates and the potential for misuse. Therefore, it is paramount to implement strict patient selection, vigilant monitoring and well-structured support mechanisms.
Key Points:
- Ketamine has shown appreciable short-term results in treating depression, but is associated with elevated relapse rates after the treatment ends.
- The likelihood of misuse of the drug is a concern, due to its potential for abuse, possible bladder-related problems, and memory side effects.
- Current recommendations advocate for controlled use of the drug, particularly for treatment-resistant depression, under the vigilant eye of known clinicians.
Overview:
Drugs such as Ketamine can significantly help manage treatment-resistant depressions, as long as its use is moderated and well-controlled. This was concluded in an editorial in the New Zealand Medical Journal by Dr. Ben Beaglehole, Associate Professor James Foulds and Professor Roger Mulder from the University of Otago.
In New Zealand, ketamine is mainly utilized for research purposes and in some limited publicly funded specialty services. Recently, private providers have also begun offering ketamine treatments. Despite the short-term improvements experienced by patients on this treatment, there is a high likelihood of relapse post-treatment. However, handling these relapses presents its own set of challenges for clinicians.
Unregulated use of the drug also brings with it a risk of abusive tendencies and other negative impacts such as bladder complications and potential memory issues. As a result, careful selection and rigorous monitoring of patients on this treatment is crucial.
The Royal Australian and New Zealand College of Psychiatrists mandate that the use of ketamine should only be restricted to treatment-resistant depression (outside of research settings), and that it should only be used where clinicians have previous experience with the drug and proper support structures are in place.
Personal Refection:
As a psychiatrist, I concur with the cautious approach suggested by the researchers. The potential benefits of ketamine are exciting, but its misuse, adverse effects, and high post-treatment relapse rates cannot be neglected. Prioritizing a controlled and well-monitored environment for its use is essential. We must remember that while new treatments bring promise, they also hold risks, and long-term patient safety should always be the utmost priority.
Dr Jonathan Edward Smith, MD, Cure of Mind