Drug dependence and prescribing ketamine for treatment-resistant depression in Australia and New Zealand.
Alistair Carroll, Adam Bayes, Mark Montebello, Jonathan Brett, Shalini Arunogiri, John B Saunders, Colleen K Loo
The Australian and New Zealand journal of psychiatry October 1, 2024 DOI: 10.1177/00048674241242315 via PubMed
Summary
AI-generated from the abstractKetamine is a restricted medication in Australia and New Zealand, with regulations that vary by jurisdiction and generally limit its use in patients who have a history of drug dependence. There is substantial variation in how drug dependence is defined legally and clinically, with clinical definitions from the ICD-11 and DSM-5. This paper reviews evidence on the risk of ketamine misuse and dependence among patients with a history of illicit drug use, abuse, or dependence, and offers recommendations for psychiatrists prescribing ketamine for treatment-resistant depression in this population.
Study at a glance
| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Depression Ketamine |
| Keywords | Drug dependence Regulations Ketamine therapy Mental health treatment Drug policy |
| Citations | 10 |
| Key finding | Regulations for ketamine prescription in treatment-resistant depression vary across Australian and New Zealand jurisdictions, and most restrict use in patients with drug dependence, with inconsistent definitions of dependence. |
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.