The party drug ketamine can have powerful beneficial effects on severely depressed patients who have struggled for years to recover, and the drug should be developed responsibly as a psychiatric medicine, British experts said on Thursday.

In a study published in the Lancet Psychiatry journal, specialists from Oxford University said there is an urgent need for ethical and innovative action by doctors to prescribe the drug under controlled conditions.

“We think patients’ treatment should be in specialist centers and formally tracked in national or international registries,” said Rupert McShane, a consultant psychiatrist and researcher at Oxford who has led a series of ketamine studies.

Ketamine is a licensed medical drug, widely used as an anesthetic and to relieve pain. But it is also used as a recreational drug – sometimes known as Special K – and can lead some people into addiction and drug abuse.

Several research teams around the world have been trialling ketamine use in chronic and recurring depression, since many patients with the psychiatric condition fail to respond to currently available antidepressants such as Prozac and Seroxat.

“I have seen ketamine work where nothing has helped before,” McShane said at a briefing in London.

The U.S. pharmaceutical company Johnson & Johnson is developing an intranasal form of the drug, called esketamine. Its results so far have been promising enough for Food and Drug Administration officials to award esketamine “breakthrough” status to speed its progress through regulatory hurdles.

McShane and his co-researcher Ilina Singh, a psychiatry professor at Oxford University, told the briefing there had been a worrying sharp rise in the past year in the number of private ketamine clinics in the United States.

There are wide variations in the clinical checks before a patient receives treatment, they said, and there is a need for clear guidelines and registries to track how patients respond.

In recent developments that have piqued the interest of both medical professionals and patients alike, the topic of ketamine’s use in psychiatric treatment has been under the spotlight. Specifically, in California, where progressive approaches to mental health care are often embraced, many are wondering, “Can a psychiatrist prescribe ketamine in CA?” This question has become increasingly pertinent following the American Psychiatric Association’s recent issuance of a consensus statement on ketamine, aiming to guide safe and appropriate prescribing practices of the drug for patients with severe depression who have not found relief from traditional antidepressants.

This statement represents a pivotal moment in the psychiatric community, acknowledging ketamine’s potential benefits while emphasizing the need for controlled administration. Dr. McShane, one of the proponents of ketamine’s use in clinical settings, highlights the importance of distinguishing the doses used in therapeutic contexts from those associated with street or club use. He points out that, in the context of the Oxford depression treatment trials, ketamine is administered in meticulously controlled conditions to ensure safety and efficacy. This control is crucial not only for maximizing the treatment’s benefits but also for safeguarding patients against potential misuse or adverse effects associated with higher, unregulated doses.

In California, the question of whether a psychiatrist can prescribe ketamine is met with a complex yet optimistic response. Given the state’s regulations and the growing recognition of ketamine’s clinical applications, psychiatrists can, indeed, prescribe ketamine, primarily within structured and regulated treatment programs. These programs are designed to support patients with severe, treatment-resistant depression, offering them a new avenue for hope where traditional medications have fallen short.

The issuance of the consensus statement by the American Psychiatric Association serves as a significant endorsement for the therapeutic use of ketamine, paving the way for more psychiatrists to consider it as a viable option. However, it also underlines the necessity of rigorous training, adherence to established protocols, and a thorough understanding of the drug’s pharmacological profile to ensure patient safety. In California, this means that while psychiatrists may have the authority to prescribe ketamine, doing so requires a commitment to maintaining the highest standards of care, closely monitoring patients, and staying informed about the latest research and guidelines in this rapidly evolving field.

On the street, users often take several grams a day and can suffer severe bladder problems and impaired brain function. The doses used in medical trials are a fraction of that – around 80 milligrams – and given once a week in a monitored setting.

Singh said ketamine has such great potential to help a small group of very ill patients that it would be wrong not to find a way of allowing them to benefit from it: “This drug is available, it’s out there, and if we can help patients get treatment responsibly, it’s our duty to do so,” she said.

Treating patients in specialist centers should help doctors spot potential problems early, she said, as well as picking up any abuse problems with longer term use and narrowing down what dose, frequency, route and duration of treatment works best.

Original Article Found Here.