Implementation of a ketamine programme for treatment-resistant depression in the public health system: Lessons from the first Australian public hospital clinic.
Nicollette Lr Thornton, Dean J Wright, Nick Glozier
Australian & New Zealand Journal of Psychiatry July 1, 2024 DOI: 10.1177/00048674241237094 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Population | Clinicians and health services considering establishing a public-sector ketamine treatment service |
| Topics | Ketamine Depression Esketamine |
| Keywords | Implementation Public hospital Ketamine therapy Mental health treatment Public healthcare access Depression treatment Medical innovation |
| Citations | 5 |
| Key findings | Establishing a public-sector ketamine treatment service is possible but involves navigating significant progress, perils, and pitfalls. |
Abstract
One could argue that we are living through a period of innovation and change in psychiatry unlike that seen before, with repurposed medications emerging as novel treatments. However, despite evidence of enhanced clinical outcomes and potential medium-term savings, delivering these promising interventions is resource-intensive and perceived as difficult in the public sector. Consequently, they are generally only available in the private sector, often at great cost, effectively making them inaccessible to the 'Have Nots'. The arrival of these paradigm-shifting treatments has inadvertently highlighted a growing mental health inequity. The Royal Prince Alfred Hospital's Ketamine Treatment Clinic was the first public-sector ketamine treatment clinic for complex mood disorders in Australia. Based on 3 years' experience establishing, developing and running a public-sector ketamine treatment service, we review the progress, perils and pitfalls for clinicians and health services contemplating establishing a public-sector ketamine treatment service of their own.
Comparable studies
Other narrative reviews on ketamine for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Ketamine: a paradigm shift for depression research and treatment | 2019 | Review | |
| Rapid‐acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective | 2019 | Review | |
| Ketamine: A tale of two enantiomers | 2020 | Review | |
| Molecular mechanisms underlying the antidepressant actions of arketamine: beyond the NMDA receptor | 2021 | Review |
Citations in the library
Cited by 4
- Ketamine in psychiatry: Ethical imperatives in harnessing a controversial yet promising therapy Australian & New Zealand Journal of Psychiatry December 11, 2025
- Improving access to novel treatments for treatment-resistant depression: The potential role of specialist clinics in Australia Australian & New Zealand Journal of Psychiatry May 26, 2026
- Protocol of an open-label safety and feasibility pilot study of ketamine-assisted psychotherapy for methamphetamine use disorder (the KAPPA trial). BMJ Open February 10, 2025
- Effectiveness and safety of repeat dose subcutaneous ketamine for treatment-resistant depression, and the impact of prior ketamine treatment: open label extension of the KADS study The British Journal of Psychiatry July 6, 2026
Cites 8
- Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation American Journal of Psychiatry March 17, 2021
- Efficacy of single and repeated administration of ketamine in unipolar and bipolar depression: a meta-analysis of randomized clinical trials Pharmacological Reports April 16, 2020
- Impact of oral ketamine augmentation on hospital admissions in treatment-resistant depression and PTSD: a retrospective study. Psychopharmacology February 1, 2018
- Safety and efficacy of extended release ketamine tablets in patients with treatment-resistant depression and anxiety: open label pilot study Therapeutic Advances in Psychopharmacology 2020
- A systematic review of the print media representation of ketamine treatments for psychiatric disorders BJPsych Open June 7, 2023
and 3 more in the library