Overview
- The Royal College of Psychiatrists recommends ketamine-based medication for depression only within specialist services with oversight and long-term monitoring.
- Esketamine, a ketamine-derived nasal spray, is licensed in the UK for treatment‑resistant depression and is available on the NHS in Scotland but not in England.
- Ketamine is the most studied agent for rapid relief of depressive symptoms, with large randomized trials and thousands of participants supporting its efficacy.
- The college says evidence for psilocybin, MDMA, LSD and similar drugs remains limited, so they should not be used routinely outside licensed programs.
- Officials warn against self‑medication or unregulated clinics and call for rigorous trials, trained staff, and better monitoring systems as policies evolve in countries such as Australia, Canada and Israel.