MHM Magazine

Depression affects many people and often limits their ability to function, necessitating safe treatment. These patients can be especially vulnerable; strict rules govern the development and use of antidepressant medicines. Ketamine, an anaesthetic drug chemically related to the hallucinogen phencyclidine, is gaining popularity with ketamine-therapy clinics offering intravenous ketamine infusions for conditions such as treatment-resistant depression, post-traumatic stress disorder, and chronic pain; however, there are concerns due to its widespread misuse. As a result, in South Africa, it’s classified as a controlled substance, and its medical use is restricted to reduce the risk of abuse. The discussion of ethical considerations is grounded in a thorough review of the evidence supporting ketamine use for psychiatric conditions, particularly treatment-resistant depression, alongside an assessment of its safety profile. This article presents the key ethical principles and theories in the context of off-label ketamine use. What is the evidence for ketamine use in clinical depression? The first study to draw attention to ketamine’s potential antidepressant effects was a small crossover trial conducted in 2000 involving seven patients with Dr Thabo Mogotlane 1 ₁ and Dr Kgothatso Matseme 2 1 Addiction specialist, Cape Town Email: tramadikela@gmail.com 2 General Practitioner-Anaesthesiology, Johannesburg Email: Kgothatso.matseme@gmail.com EVALUATING THE ETHICAL IMPLICATIONS OF OFF-LABEL KETAMINE USE IN CLINICAL PRACTICE MHM | 2025 | Volume 12 | Issue 5 | Evaluating the ethical implications of off-label ketamine use in clinical practice MHM 20 | MENTAL HEALTH MATTERS | 2025 | Issue 5 H