Specialists endorse ketamine as an effective therapy for depression, yet caution that further investigation is required for other psychedelics whose popularity is rapidly increasing.
The Royal College of Psychiatrists (RCPsych) has issued a new position statement on the use of psychedelic and related substances for medical purposes, including ketamine and methylenedioxymethamphetamine (MDMA).
According to the statement, ketamine has shown promising results in treating depression, making it the most studied drug in the rapid relief of depressive symptoms. Ongoing and completed trials are investigating its effects on various mental disorders such as obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), alcohol or cocaine abuse, in addition to depression.
One such development is the nasal spray esketamine, a derivative of ketamine, which is already licensed in the UK for treatment-resistant depression. However, RCPsych recommends its use only in specialist settings with appropriate oversight.
Professor Oliver Howes, Chairman of RCPsych's Psychopharmacology Committee, emphasized the scarcity of new treatments for mental disorders, stating that they are "very rarely developed." He added, "On average, just one new treatment for mental disorders is licensed every 10 years, compared to four times as many in neurology and 10 times as many for cancer."
Dr Jo O'Reilly, Chair of the RCPsych Medical Psychotherapy Faculty, emphasized the importance of properly trained staff in the use of psychedelics. She highlighted that they can have a profound effect on the mind and may make some people more responsive to psychotherapy. She also stressed the importance of supporting patients to process and find meaning in their experiences when using psychedelics.
However, RCPsych has warned of the risk of claims around psychedelics "jumping ahead of the evidence." The international legal status of psychedelics is a "rapidly changing area," and RCPsych expects new findings to emerge in the coming years regarding their use for medical purposes.
It is important to note that ketamine is currently a Class B drug, used in clinical settings as an anaesthetic for people and animals. However, its recreational use has been on the rise, with the number of children and young people who reported having a problem with the drug surpassing cocaine for the first time between 2023 and 2024.
In conclusion, while the potential benefits of psychedelics and related substances for medical use are promising, their use should be approached with caution and appropriate oversight. The role of properly trained and supervised therapists cannot be overstated in supporting patients to process and find meaning in their experiences when using these substances.
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