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Rupert McShane

Department of Psychiatry, Oxford University, UK; and Oxfordshire ECT and Ketamine Service, Oxford, UK.

4 papers in the library · 47 citations · publishing 2019-2026

Papers

Ketamine treatment for individuals with treatment-resistant depression: longitudinal qualitative interview study of patient experiences

BJPsych Open January 1, 2021 Karen Lascelles, Lisa Marzano, Fiona Brand et al. 20 citations

Twelve fee-paying patients with treatment-resistant depression (ages 21–70, six women and six men, most reporting suicidality and some reporting self-harm) were interviewed before, during, and months after starting ketamine treatment in a routine clinic. Nearly all experienced mood improvement after initial treatments, ranging from negligible to dramatic, and eight reported reduced suicidality. Improvements were generally transitory; two patients had sustained consistent benefit and two had sustained but limited improvement. Some described hopelessness when treatment stopped working, and three experienced increased suicidal ideation. Side-effects were common and significant for two patients. Treatment cost and lack of longer-term benefit were problematic. Suggestions included closer monitoring and adjunctive therapy.

Exploring patients’ and carers’ views about the clinical use of ketamine to inform policy and practical decisions: mixed-methods study

BJPsych Open July 29, 2019 Sagar Jilka, Claire A. Murray, Ania M. Wieczorek et al. 20 citations

Patients and carers want better evidence on the long-term safety of ketamine for major depression and feel that monitoring is required, though they worry about misuse of that information. Practical barriers such as repeated travel to clinics and lack of sufficiently informed medical staff are key concerns. The study used 44 participants in 21 focus groups and an online survey, generating ten themes including monitoring, information, side-effects, recreational use, effectiveness, cost, stigma, and therapy.

Guidelines for ketamine use in clinical psychiatry practice.

BJPsych open May 10, 2024 Luke A Jelen, Rupert McShane, Allan H Young 7 citations

Ketamine shows promise for treatment-resistant depression, but its use requires careful management through evidence-based guidelines. The editorial emphasizes the need for comprehensive protocols to oversee both licensed and off-licence ketamine formulations, referencing recent efforts to develop such guidelines in New Zealand. It advocates for national registries to monitor ketamine therapy, ensuring responsible and effective treatment for depression.

Ketamine attenuates habenula activity in response to aversive outcomes during Pavlovian learning

bioRxiv (Cold Spring Harbor Laboratory) February 10, 2026 Erdem Pulcu, Sara Costi, Pilar Artiach-Hortelano et al.

A single sub-anesthetic dose of ketamine reduces activity in the lateral habenula, a small midbrain structure involved in aversive learning, when healthy volunteers expect or experience unpleasant stimuli a day later. In a randomized trial with 70 adults, those who received ketamine showed attenuated habenula responses during an aversive Pavlovian conditioning task measured with 7-Tesla functional neuroimaging. Preliminary evidence suggests that reduced habenula activity during aversive learning may weaken the emotional impact of negative memories. These results support preclinical models of how ketamine may rapidly relieve depression by acting on the human habenula.