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Don’t prescribe ketamine for depression… yet: expert

Don’t prescribe ketamine for depression… yet: expert - Featured Image

Medical practitioners shouldn’t be pressured to prescribe ketamine as a depression treatment until clinical trials are complete.

Professor Colleen Loo from the University of New South Wales and the Black Dog Institute in Sydney, writes in the Medical Journal of Australia that there is still research to do on its long term use.

Ketamine is an anaesthetic and analgesic drug, and although single-dose trials show promise, there are still challenges in understanding its effectiveness as a long-term option.

“Some clinics in Australia and overseas have begun offering a course of ketamine treatments to patients with depression”, Professor Loo wrote.

“However, this practice is premature, given that the efficacy and safety of this treatment approach has yet to be tested in controlled trials. Further, whether such a treatment approach leads to lasting response — that is, clinically meaningful effects — is as yet unknown.”

Related: MJA – Occupational impact of internet-delivered cognitive behaviour therapy for depression and anxiety: reanalysis of data from five Australian randomised controlled trials

As a single dose, ketamine takes effect within 24 hours and small preliminary study suggests it may even compare to electroconvulsive therapy in its effectiveness which is considered the “most effective proven biological treatment” for depression.

However the effects of ketamine only last a few days after the treatment.

Uncontrolled data from recreational users suggest risks include liver damage, bladder dysfunction, cognitive impairment and possible addiction.

“If ketamine is prematurely applied clinically to treat depression, before research has determined how (and if) it can be effectively and safely used to achieve lasting remission of depression, the end result may be disillusionment and even abandonment of this otherwise most promising therapy,” Professor Loo writes.


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