Initially identified in the early ’60s for its anaesthetic properties in veterinary use, ketamine is now on the World Health Organisation’s List of Essential Medicines. It has also been abused for its properties over decades – but with a balanced view and cautious approach, ketamine can have potentially life-saving applications in psychiatric medicine. Ethical ketamine treatment Psychiatrist Dr Bavi Vythilingum practises at Netcare Akeso Kenilworth and Ukukhanye Wellness, a psychiatrist-led ketamine clinic that focuses on evidence-based ethical ketamine treatment.
She emphasises its usefulness for certain patients but also warns health care practitioners and the general public about misinformation and the inappropriate use of the drug. “Ketamine is a pharmacologically novel treatment with proven efficacy in major depressive disorder. “It is one of the first non-monoaminergic treatments, which means not involving the balance of hormones, such as serotonin or norepinephrine.
“There are major safety concerns when it is used irresponsibly or illegally, even in controlled, licensed psychiatric settings,” says Vythilingum. “It is essential that it is only ever administered in line with the clinical guidelines to appropriate patients where all else has failed to bring relief to treatment resistant depression or bipolar depression, suicidality, or post-traumatic stress disorder.” Vythilingum says fewer than 15% of people with treatment-resistant depression achieve r.