Ketamine could be used to treat depression in clinical settings, but experts have warned further research is needed into other psychedelic drugs.
The Royal College of Psychiatrists (RCPsych) has backed the use of ketamine-based medication, and said it has been “the most studied in the rapid relief of depressive symptoms”, with evidence showing it could be effective in large drug trials.
Currently a Class B drug, ketamine is used in clinical settings as an anaesthetic for people and animals, but it is also used recreationally, to harmful effect. Between 2023 and 2024, the number of children and young people who reported having a problem with the drug surpassed cocaine for the first time.
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RCPsych warned, while it is “vital” new treatments for mental health conditions are developed, there is a risk of claims around psychedelics “jumping ahead of the evidence” and the “hype” should not be “prioritised above good clinical practice”.
RCPsych laid out its stance on psychedelic and related substances for medical use, including pharmacological versions of hallucinogens, ketamine and methylenedioxymethamphetamine (MDMA), in a new position statement.
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Ketamine has been used in studies involving thousands of patients to explore the impact of depression, RCPsych said, and there are also ongoing and completed trials looking at how it affects people with obsessive-compulsive disorder, post-traumatic stress disorder (PTSD) and alcohol or cocaine abuse.
A drug derived from ketamine – a nasal spray known as esketamine – is already licensed in the UK for treatment-resistant depression.
But RCPsych said it would only recommend the use of ketamine in specialist settings with appropriate oversight.
‘New treatments are rarely developed’
Professor Oliver Howes, chairman of RCPsych’s psychopharmacology committee, said new treatments for mental disorders are “very rarely developed”.
“It’s vital that trend is reversed,” he said.
On average, just one new treatment for mental disorders is licensed every 10 years – compared with four times as many in neurology and 10 times as many for cancer, he said.
But the college said new findings will likely emerge in the coming years, with the international legal status of psychedelics a “rapidly changing area”.
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Dr Jo O’Reilly, chairwoman of RCPsych’s medical psychotherapy faculty, said properly trained staff are “key”.
“Psychedelics can have a profound effect on the mind and may make some people more responsive to psychotherapy,” she said.
“Patients often find their psychological defences are lowered which allows traumatic and unpredictable material to emerge.”
This means, she said, the use of properly trained and supervised therapist is key in supporting patients to process and find meaning in their experiences.
