Ketamine treatment for depression: opportunities for clinical innovation and ethical foresight.
Ilina Singh, Celia Morgan, Valerie Curran, David Nutt, Anne Schlag, Rupert McShane
Lancet Psychiatry April 5, 2017 DOI: 10.1016/s2215-0366(17)30102-5 via PubMed
Summary
AI-generated from the abstractBased on current evidence, off-label ketamine use for severe, treatment-resistant depression does not violate ethical principles, but clinicians and professional bodies must establish guidelines for good practice, register all trial data, and continuously monitor risks. The analysis reviews evidence for ketamine's antidepressant effects and safety profile, concluding with recommendations for oversight bodies to support safe, effective, and ethical treatment.
Study at a glance
| Characteristics | Review and analysis Peer reviewed |
|---|---|
| Keywords | Ketamine treatment ketamine Powerful intervention Fast-acting antidepressant effects Depression treatment depression Severe depression |
| Citations | 158 |
| Key finding | Off-label ketamine use for severe, treatment-resistant depression does not violate ethical principles, provided guidelines for good practice are enacted, trial data are registered, and risks are monitored. |
Abstract
We present a review and analysis of the ethical considerations in off-label ketamine use for severe, treatment-resistant depression. The analysis of ethical considerations is contextualised in an overview of the evidence for ketamine use in depression, and a review of the drug's safety profile. We find that, based on current evidence, ketamine use for severe, treatment-resistant depression does not violate ethical principles; however, clinicians and professional bodies must take steps to ensure that guidelines for good practice are enacted, that all experimental and trial data are made available through national registries, and that the risk potential of ketamine treatment continues to be monitored and modelled. We conclude with a set of key recommendations for oversight bodies that would support safe, effective, and ethical use of ketamine in depression.