Experts back ketamine for depression but urge caution on psychedelics ‘hype’

The Royal College of Psychiatrists says large trials suggest ketamine-based drugs may ease depression symptoms.

Experts have backed the use of ketamine in depression treatment, while stressing that more evidence is needed before other psychedelics can be considered safe.

The Royal College of Psychiatrists (RCPsych) issued a position statement highlighting ketamine, saying it is “the most studied in the rapid relief of depressive symptoms”.

It referred to data from large trials showing potential benefit.

Ketamine, a Class B drug, is used as an anaesthetic in hospitals and veterinary care. Recreational misuse has been linked to serious health problems.

Figures from 2023–24 showed cases of harm among children and young people from ketamine exceeded those linked to cocaine for the first time.

The college warned that while new mental health therapies are “vital”, there is a danger that “hype” around psychedelics could be “prioritised above good clinical practice.”

RCPsych’s statement sets out its position on psychedelics and related drugs in medicine.

These include pharmacological versions of hallucinogens such as ketamine and methylenedioxymethamphetamine (MDMA) – commonly known as ecstasy.

Dr Jo O’Reilly, chairwoman of RCPsych’s medical psychotherapy faculty, said properly trained staff are “key”.

“Psychedelics can have a profound effect on the mind and may make some people more responsive to psychotherapy,” she said.

“Patients often find their psychological defences are lowered which allows traumatic and unpredictable material to emerge.”