OPEN Foundation

E. Wilson

Ketamine treatment for depression: qualitative study exploring patient views

Abstract

Background: Ketamine is a new and promising treatment for depression but comes with challenges to implement because of its potential for abuse.

Aims: We sought the views of patients to inform policy and practical decisions about the clinical use of ketamine before large-scale roll-out is considered.

Method: This qualitative study used three focus groups and three validation sessions from 14 patients with prior diagnoses of depression but no experience of ketamine treatment. Focus groups explored their views about clinical use of ketamine and the best way for ketamine to be administered and monitored. The qualitative data were analysed by three service-user researchers using thematic analysis.

Results: Five themes were generated: changing public perceptions, risks, monitoring, privacy and data protection, and practical aspects. Participants were conscious of the stigma attached to ketamine as a street drug and wanted better public education, and evidence on the safety of ketamine after long-term use. They felt that monitoring was required to provide evidence for ketamine’s safe use and administration, but there were concerns about the misuse of this information. Practical aspects included discussions about treatment duration, administration and accessibility (for example who would receive it, under what criteria and how).

Conclusions: Patients are enthusiastic about ketamine treatment but need more information before national roll-out. The wider societal impact of ketamine treatment also needs to be considered and patients need to be part of any future roll-out to ensure its success.

Jilka, S., Odoi, C. M., Wilson, E., Meran, S., Simblett, S., & Wykes, T. (2021). Ketamine treatment for depression: qualitative study exploring patient views. BJPsych open, 7(1), e32. https://doi.org/10.1192/bjo.2020.165

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Autistic Schizophrenic Children: An Experiment in the Use of D-Lysergic Acid Diethyladmide (LSD-25)

Introduction

Since the hallucinogenic properties of D-lysergic acid diethylamide (LSD-25) were accidentally discovered by Hoffman in 1943 there has been wide experimentation with the drug designed to test its properties both as a psychotomimetic and as a therapeutic agent. It has been considered by some investigators as having great value in revealing the nature of the schizophrenic state and thereby advancing the understanding that leads to progress in therapy. However, other investigators, while acknowledging the undoubted psychic effects of the drug, insist that the LSD experience cannot be equated with naturally occurring psychosis.1 It is not the first psychopharmaceutical agent to be used as an adjunct to psychotherapy; most of its predecessors were greeted with equal enthusiasm by some because of their action in unlocking the gates of repression and thus leading to disinhibition and catharsis. In fact, according to Hoch,2 careful studies…

Freedman, A. M., Ebin, E. V., & Wilson, E. A. (1962). Autistic schizophrenic children: An experiment in the use of d-lysergic acid diethylamide (LSD-25). Archives of General Psychiatry, 6(3), 203-213. https://dx.doi.org/doi:10.1001/archpsyc.1962.01710210019003
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