Monitoring of Clinics That Use Direct-to-Consumer Advertising for Off-Label Ketamine in the New York Metropolitan Area: A Cross-Sectional Systematic Web Search.
Nina Abukahok, Steven Lawrence, Samrachana Adhikari, Samuel T. Wilkinson, Joseph J Palamar
Fundamental & clinical pharmacology July 1, 2026 DOI: 10.1111/fcp.70095 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional study Peer reviewed |
|---|---|
| Sample size | 233 |
| Population | Clinics advertising ketamine for psychiatric conditions online in the New York metropolitan area |
| Intervention | ketamine |
| Topics | Ketamine Esketamine |
| Keywords | Direct‐to‐consumer advertising Off‐label prescribing Telehealth |
| Key findings | Over a third of clinics (36.5%) advertised ketamine for at-home use, and advertising oral ketamine was strongly associated with offering at-home use, while listing a medical doctor was associated with lower likelihood of such advertising. |
Abstract
Ketamine is increasingly prescribed in an off-label manner to treat psychiatric disorders, raising concerns about direct-to-consumer advertising and the proliferation of clinics offering ketamine for at-home use without direct medical supervision. We aimed to identify and characterize clinics advertising ketamine for psychiatric conditions online in the New York metropolitan area (New York, New Jersey, and Connecticut), with attention to advertising suggesting ketamine is prescribed for at-home use. In 2025, systematic web searches were conducted to identify clinics advertising prescription ketamine for psychiatric indications. Public-facing website content was reviewed to describe clinic characteristics: service delivery modality, clinician credentials, routes of administration, disorders treated, and advertising practices. A generalized linear model was used to delineate correlates of clinics advertising ketamine for at-home use. 233 clinics were located; 36.5% prescribed ketamine for at-home use. 51.5% listed a medical doctor as part of their team and 42.9% advertised oral ketamine. Depression was the most commonly listed disorder treated (94.0%) and 21.9% advertised ketamine to treat substance use disorder. In the multivariable model, advertising ketamine for at-home use was more common among clinics advertising oral ketamine (aPR = 4.10, 95% CI: 2.20-7.60) and less common among clinics listing a medical doctor (aPR = 0.54, 95% CI: 0.30-0.99). Over a third of clinics advertised ketamine for at-home use. A limitation is that we only focused on public-facing websites. Advertising practices and clinician representation suggest clinics may be advertising in a more consumer-oriented manner, underscoring the need for monitoring and clearer guidance to mitigate potential safety risks.
Comparable studies
Other cross-sectional and survey studies on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 5-Year Trends in Use of Hallucinogens and Other Adjunct Drugs among UK Dance Drug Users People who use drugs in dance contexts | 2006 | Repeated-measures cross-sectional survey | |
| Preliminary analysis of positive and negative syndrome scale in ketamine-associated psychosis in comparison with schizophrenia Healthy subjects, ketamine abusers, and schizophrenia patients | 2014 | Cross-sectional study | n = 998 |
| Ketamine as a primary predictor of out-of-body experiences associated with multiple substance use Online survey respondents | 2011 | Cross-sectional survey | n = 192 |
| Self-reported prevalence of dependence of MDMA compared to cocaine, mephedrone and ketamine among a sample of recreational poly-drug users Global non-treatment-seeking sample of last year users of MDMA, cocaine, mephedrone,... | 2014 | Cross-sectional survey | |
| Near-Death States Reported in a Sample of 50 Misusers Previous ketamine misusers who reported a ketamine-related near-death experience | 2010 | Cross-sectional survey | n = 50 |