A new report recommended that ketamine therapy be used only in combination with psychotherapy under the supervision of a clinician.
All Points North (APN) released its 2023 Future of Mental Health: Ketamine Therapy Report, which examined opinions on and experiences with ketamine therapy, including at-home ketamine treatments.1 Researchers surveyed 2000 adults and found that 64% of those taking ketamine said it helped with their mental health symptoms; however, 55% of all Americans and 58% of millennials who tried at-home ketamine therapy reported accidentally or purposefully using more than the recommended dose. Additionally 26% agree they would rather use ketamine than antidepressants or antianxiety medications.
“When researching or suggesting any new mental health treatment, care for the patient and an evaluation of its benefits in tandem with their ongoing treatment plan and goals should come first and foremost. When it comes to ketamine-assisted therapy, there are telehealth options that make the use of psychedelics seem harmless and easy to do at home, unsupervised, but these companies far too often take a backseat when it comes to the therapy aspect, often leaving patients to fend for themselves, which leads to accidental misuse or abuse of the drug,” said Noah Nordheimer, founder and CEO of APN, an addiction treatment center in Colorado.
The report recommended that ketamine therapy be used only in combination with psychotherapy under the supervision of a clinician, as risk exponentially increases when patients self-medicate: 1 in 5 (21%) of respondents reported using ketamine or other psychedelic drugs for the purpose of self-treating anxiety, depression, or other mental illnesses.
“Ketamine is a Schedule 3 controlled drug and has a long history of diversion and abuse with significant negative health consequences. Ketamine is not FDA approved for any psychiatric disorder—rather, only as an anesthetic,” said John J. Miller, MD, Editor in Chief of Psychiatric Times®. “Esketamine, an active component of ketamine, was FDA approved in 2019 for treatment-resistant depression. For this indication, the FDA requires a strict Risk Evaluation and Mitigation Strategy (REMS) due to potentially serious adverse events, including dissociation and high blood pressure, as well as risk for abuse. Esketamine has to be administered in person by a trained health care provider. The use of at-home ketamine bypasses this safety net and puts individuals at risk, undermining the FDA’s REMS protocol to minimize risk and maximize safety and prevent diversion and abuse/misuse.”
Nordheimer echoed this sentiment. “Patients seeking the help of psychedelics should look for options that include clinical supervision and a trusted team of therapists, beginning with an in-person assessment and evaluation of the patient’s unique needs and goals.”
Millennials and members of Gen Z and Gen X are more likely to try ketamine compared with baby boomers; they are also more likely to abuse or misuse ketamine. Approximately 2 in 5 (41%) Gen Zers reported self-medication with ketamine or other psychedelics, and 1 in 3 (29%) millennials reported using ketamine or other psychedelic drugs for the purpose of recreation or experimentation.
“Mental health therapies should only be used in the way peer-reviewed studies for clinical validation have deemed them safe,” Nordheimer said. “Even then, we should carefully evaluate who is best suited for which treatments, as mental health is not one size fits all. Oversimplified at-home ketamine offerings can result in patients irresponsibly self-medicating or becoming dependent; it’s also less likely to help them in the long run.”