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Patients, carers and advocates say better evidence is needed on the safety of ketamine for depression after long-term use, and that those prescribed it must be closely monitored.

Esketamine and arketamine diagram
Copyright © 2019 Pharmacist Answers

A study undertaken as part of a collaboration between the NIHR Maudsley Biomedical Research Centre (BRC) and NIHR Oxford Health Biomedical Research Centre (BRC), Exploring patients'and carers' views about the clinical use of ketamine to inform policy and practical decisions: mixed-methods study, was published on 30 July in the Royal College of Psychiatrists' BJPsych Open.

The study explored attitudes among four groups: people considering ketamine as an antidepressant, people who have already used ketamine for depression, people with experience of illegal drug use and addiction, and patient advocates and carers. 44 people took part in 21 focus groups, and an online survey captured the views of patients, carers and advocates during a consultation day.

The majority (63 per cent) of participants felt careful monitoring of people using ketamine was required, both to gather evidence on effectiveness and side-effects, and to ensure safe use and administration. Most participants felt that the best system was to administer ketamine in a clinic on the first few occasions, then allow it to be taken at home to self-administer. However, there were mixed views across the group which require further investigation. Some had concerns about the risks of home administration, as well as about the lack of understanding of the drug among health professionals, and the stigma of ketamine as a party drug. Some participants were concerned about their ability to drive, work or care for their children responsibly after ketamine use, while others felt more information is needed about what experiences are normal or not when taking the drug. On the whole, however, those consulted felt the potential benefits outweighed the risks.

 

Most participants thought that patients should provide information about their use of ketamine and their mood in order to be prescribed ketamine. They also felt that health information is too often not shared. Monitoring systems need to be joined up and not separate from clinical care. - Joint senior author of the study, Professor Rupert McShane, Oxford Health Biomedical Research Centre.

 

To read the full press release.

To read a BMJ blog by Rupert McShane: A drug not a miracle - why we need a new system for monitoring ketamine.

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