BJPsych Open
June 7, 2023
Nicollette Thornton, Jason Kawalsky, Alyssa Milton et al.
11 citations
A systematic review of 119 print and online news articles from 2015 to 2020 found that media coverage of ketamine for psychiatric disorders was extremely positive (68.9% of articles). The rapid antidepressant effect was frequently emphasized (73.1% of articles), while longer-term safety and efficacy received little attention. Side-effects were reported in 80.7% of articles, mainly acute psychotomimetic effects and addiction risk, but rarely cardiovascular or bladder effects. Key opinion leaders, such as clinicians, often provided overly optimistic quotes that went beyond the existing evidence base. The authors conclude that information shaping patient expectations is being communicated through the media, and clinicians should address patients' beliefs directly.
Australian & New Zealand Journal of Psychiatry
April 16, 2024
Samuel P Hatfield, Nicollette Lr Thornton, Kayla Greenstien et al.
9 citations
The Australian government's recent rescheduling of psilocybin and MDMA for limited clinical use has raised regulatory challenges for psychedelic-assisted therapy. Through a desktop review, interviews with experts, and framework analysis, researchers developed a taxonomy of regulatory matters across six domains. Three domains—Service Establishment, Practitioner, and Treatment Delivery—contain many matters with uncertainty or conflicting views, such as where services should be located and which professionals qualify as therapists. The remaining domains—Patient Evaluation, Drug Supply, and Service Oversight—are relatively settled, with established regulation or consensus that regulation is unnecessary. The taxonomy offers a roadmap for health services and policymakers.
The Australian and New Zealand journal of psychiatry
February 1, 2024
Anthony Rodgers, Dilara Bahceci, Christopher G Davey et al.
8 citations
The repurposing of generic racemic ketamine for severe depression has been delayed and uncoordinated for over 20 years due to insufficient commercial incentives, while a patented intranasal formulation (Spravato) gained widespread registration through substantial commercial investment. Spravato costs $600-$900 per dose compared to about $5 per dose for generic ketamine, and an annual government investment of approximately AUD$100 million in Australia was rejected twice, leaving the treatment largely inaccessible. Emerging evidence suggests generic ketamine is at least as effective as Spravato, but no comparative trials have been conducted. Without systemic reforms—including commercial incentives, public funding, reduced regulatory barriers, and coordinated international support—this pattern will repeat with new psychedelic treatments.
The Australian and New Zealand journal of psychiatry
July 1, 2024
Nicollette Lr Thornton, Dean J Wright, Nick Glozier
5 citations
Innovative psychiatric treatments like ketamine therapy are emerging, but their resource-intensive nature makes them largely available only in the costly private sector, widening mental health inequity for those who cannot afford them. The Royal Prince Alfred Hospital's Ketamine Treatment Clinic, Australia's first public-sector clinic for complex mood disorders, offers a model. Based on three years of experience, the authors review the progress, perils, and pitfalls for clinicians and health services considering establishing a public-sector ketamine treatment service.
The British journal of psychiatry : the journal of mental science
January 7, 2025
Natalie T Mills, Stevan Nikolin, Nick Glozier et al.
3 citations
Anxiety disorders and treatment-resistant major depressive disorder (TRD) often occur together. In a randomized controlled trial comparing subcutaneous ketamine to midazolam in 174 people with TRD, ketamine reduced anxiety only when given at flexible, response-guided doses (0.5-0.9 mg/kg). At a fixed low dose (0.5 mg/kg), the reduction in anxiety was not statistically significant. The anxiety-reducing effect was linked to overall depression improvement and was not sustained four weeks after treatment ended. The findings suggest that adequate dosing is necessary for ketamine's anxiolytic effect in this population.
BMJ Open
November 26, 2022
Nick Glozier, Ben Colagiuri, Dean J Wright
3 citations
Mental health professionals' attitudes toward a trial of MDMA-assisted psychotherapy did not differ overall from their attitudes toward a neutrally labeled pharmacotherapy trial. Psychiatrists were less willing to recommend participation in the MDMA-AP trial than in the control trial. Psychologists and researchers showed no differences. More experienced professionals had greater concern and stronger objections to the MDMA-AP trial than less experienced ones. The findings suggest that certain mental health professionals, particularly experienced psychiatrists, may be hesitant about MDMA-AP, which could pose barriers to its research and implementation.
Journal of affective disorders
October 15, 2025
Mary Lou Chatterton, Johana Kevin Perez, Thao Thai et al.
2 citations
Subcutaneous ketamine appears cost-effective for treatment-resistant depression from a health sector perspective when the costs of the control treatment (midazolam) are included, but not from a societal perspective. A cost-utility analysis alongside a randomized controlled trial with 174 participants compared ketamine to midazolam given twice weekly for four weeks. At the end of the trial, quality of life scores were significantly higher for ketamine. When control arm costs were included, ketamine was less costly and more effective, with an 89% probability of being cost-effective at a $50,000 per quality-adjusted life year threshold. Excluding those costs made ketamine not cost-effective, highlighting the importance of comparator choice.
The British Journal of Psychiatry
July 6, 2026
Nick Glozier, Richard W. Morris, Elizabeth Stratton et al.
A 4-week course of subcutaneous racemic ketamine produced short-term clinical benefit in a minority of people with treatment-resistant depression, with response rates declining substantially after treatment cessation. Among 130 participants, 30% responded at treatment end (Montgomery-Åsberg Depression Rating Scale reduction ≥50%), but only 17% remained responders 4 weeks later, and over 50% experienced less than a 25% reduction in depression scores. No difference in response was found between fixed and flexible dosing regimens. Prior ketamine treatment during an earlier randomized trial did not affect later outcomes. No suicides or suicidal behavior requiring admission occurred, and only expected side effects were observed.
Archives of suicide research : official journal of the International Academy for Suicide Research
May 9, 2026
Gregory Carter, Maree Hackett, Stevan Nikolin et al.
Ketamine's effect on suicidal ideation in adults with treatment-resistant depression remains uncertain. In a phase III double-blind randomized trial comparing subcutaneous racemic ketamine to midazolam over four weeks, one cohort showed no significant difference between groups on either the MADRS item 10 or the C-SSRS measure of suicidal ideation. A second cohort showed a non-significant reduction on the MADRS item 10 but a significant reduction on the C-SSRS. Baseline suicidal ideation scores were low in both cohorts. Adverse events requiring clinical review occurred in 13.8% of all treatment sessions. The authors suggest flexible-dose subcutaneous racemic ketamine may have beneficial effects on suicidal ideation scores, but future studies need to be powered for suicidal ideation as a primary outcome.