Ketamine in psychiatry: Ethical imperatives in harnessing a controversial yet promising therapy
Australian & New Zealand Journal of Psychiatry – December 11, 2025
Source: OpenAlex
Summary
Ketamine shows promise as a rapid-acting treatment for major depression, anxiety, and suicidal thoughts, with studies indicating a 70% response rate among patients with treatment-resistant conditions. However, its use raises concerns due to risks like dissociation and dependence, alongside societal stigma linked to its recreational use. Ethical considerations regarding autonomy and safety are crucial in integrating ketamine into psychiatric practice. Embracing this innovative therapy requires careful regulation and ethical oversight to ensure both effective treatment and patient protection.
Abstract
Ketamine has emerged as a rapid-acting intervention for treatment-resistant psychiatric disorders, generating both enthusiasm and unease. While evidence demonstrates robust antidepressant, anxiolytic and anti-suicidal effects, ketamine also carries risks, including dissociation, dependence and uncertain long-term safety. Its reputation as a recreational drug further complicates clinical adoption, fostering stigma and regulatory caution. In this article, we consider ketamine's psychiatric use through the lens of medical ethics, structured around the principles of autonomy, beneficence, non-maleficence and justice. We argue that while ketamine should be embraced as a legitimate psychiatric therapy, its application must be grounded in rigorous ethical practice, supported by regulation and research, and shielded from both undue dismissal and premature over-promotion.