Ketamine in psychiatry: Ethical imperatives in harnessing a controversial yet promising therapy
Adem T. Can, Jim Lagopoulos, Paul B Fitzgerald, Neil W. Bailey, Megan Dutton
Australian & New Zealand Journal of Psychiatry December 11, 2025 DOI: 10.1177/00048674251396009 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Topics | Esketamine Ketamine |
| Citations | 2 |
| Key points | Argues that ketamine should be embraced as a legitimate psychiatric therapy but must be applied with rigorous ethical practice, regulation, and research, avoiding both undue dismissal and premature over-promotion. |
Abstract
Ketamine has emerged as a rapid-acting intervention for treatment-resistant psychiatric disorders, generating both enthusiasm and unease. While evidence demonstrates robust antidepressant, anxiolytic and anti-suicidal effects, ketamine also carries risks, including dissociation, dependence and uncertain long-term safety. Its reputation as a recreational drug further complicates clinical adoption, fostering stigma and regulatory caution. In this article, we consider ketamine's psychiatric use through the lens of medical ethics, structured around the principles of autonomy, beneficence, non-maleficence and justice. We argue that while ketamine should be embraced as a legitimate psychiatric therapy, its application must be grounded in rigorous ethical practice, supported by regulation and research, and shielded from both undue dismissal and premature over-promotion.