Drug dependence and prescribing ketamine for treatment-resistant depression in Australia and New Zealand.
The Australian and New Zealand journal of psychiatry – October 01, 2024
Source: PubMed
Summary
Ketamine shows promise in treating severe depression, but its history as a recreational drug creates unique challenges. While regulations in Australia and New Zealand allow ketamine for treatment-resistant depression, restrictions vary by region - especially for patients with past drug dependence. Current evidence suggests careful prescribing can help balance treatment benefits with dependency risks.
Abstract
Ketamine is a restricted and regulated medication in Australia and New Zealand, which has implications when considering treatment for patients with treatment-resistant depression and a history of illicit drug use, abuse or dependence. Regulations governing prescription of ketamine for treatment-resistant depression vary between jurisdictions in Australia and New Zealand, though most restrict use in those with drug dependence. There is substantial variation in definitions of drug dependence used in each jurisdiction, and between the legal and clinical definitions, with the latter specified in the current International Classification of Diseases, Eleventh Revision and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This paper reviews the literature assessing the risk of ketamine misuse and dependence in patients with a history of illicit drug use, abuse or dependence and presents recommendations for psychiatrists who prescribe ketamine in such patients with treatment-resistant depression.