The anaesthetic drug ketamine can bring life-saving hope for people suffering from treatment-resistant major depression or at severe risk of suicide , but unsupervised use or excessive dosages hold addictive and even lethal risks.
This is the warning sounded by the South African Society of Psychiatrists (SASOP) against the recreational or unsupervised use of a drug for which scientific evidence is mounting worldwide as a new treatment for adults with severe depression that has not improved with conventional anti-depressant treatments.
There is good evidence that ketamine in low doses, administered under controlled conditions with the necessary medical supervision, is an effective treatment for treatment-resistant major depression . It is also effective in acute cases of suicidal ideation, rapidly reducing the risk of life-threatening thoughts and acts, says SASOP spokesperson, psychiatrist Dr Bavi Vythilingum.
However, ketamine is a powerful anaesthetic agent and a too-high dose can cause sedation and loss of consciousness, and in very high doses may cause dangerously slow breathing and the risk of death.
Even at lower doses, if administration of ketamine is not adequately supervised and the person is not in a safe, controlled setting they may become confused and inadvertently harm themselves. Ketamine is also potentially addictive and open to abuse.
