Overview

• The Royal College of Psychiatrists recommends ketamine-based treatment for depression only in specialist services with oversight and long-term monitoring.
• Esketamine, a ketamine-derived nasal spray, is licensed for treatment-resistant depression and available on the NHS in Scotland but not in England.
• The college highlights ketamine as the most studied rapid-acting option, citing large randomized trials and thousands of participants.
• Other psychedelic drugs are not recommended for routine clinical use due to blinding challenges in trials, side effects, and uncertain durability of benefit.
• Patients are urged to avoid self-medication and unregulated clinics, with experts calling for trained teams, rigorous research, and noting international regulated pathways in Australia, Canada, Israel, and other jurisdictions.