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.
Comparable studies
Other theoretical and historical papers on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| From PCP to MXE: a comprehensive review of the non-medical use of dissociative drugs. | 2014 | Historical analysis | |
| A Dendrite-Focused Framework for Understanding the Actions of Ketamine and Psychedelics | 2020 | Theoretical or philosophical paper | |
| Neuroscience and the Near-Death Experience: Roles for the NMSA-PCP receptor, the sigma receptor and the endopsychosins | 1990 | Theoretical or philosophical paper | |
| A unified model of ketamine's dissociative and psychedelic properties. | 2022 | Theoretical or philosophical paper | |
| An Integrative Approach to Ketamine Therapy May Enhance Multiple Dimensions of Efficacy: Improving Therapeutic Outcomes With Treatment Resistant Depression. | 2021 | Theoretical or philosophical paper |
Citations in the library
Cites 17
- The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis American Journal of Psychiatry October 3, 2017
- Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder JAMA Psychiatry April 16, 2014
- Side-effects associated with ketamine use in depression: a systematic review. The Lancet Psychiatry 2018
- Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy Journal of Psychoactive Drugs March 15, 2019
- A Single Ketamine Infusion Combined With Mindfulness-Based Behavioral Modification to Treat Cocaine Dependence: A Randomized Clinical Trial. American Journal of Psychiatry June 24, 2019
and 12 more in the library