Ketamine is known as both a party drug and a horse tranquiliser. But now it is to be offered to Scots suffering severe depression for the first time at a private clinic in South Lanarkshire.
The treatment, which will involve doses of ketamine, is already available through NHS trusts in both London and Oxford. Patients must pay for the drug and are advised not to undergo treatment unless they can afford at least £3,000 per year. It is also offered by private clinics in England.
Now the Eulas Clinic in Hamilton has become the first Scottish provider to go through the regulatory process allowing them to offer the drug for treating depression where other medication and therapies have not succeeded.
Clinic directors hope it will be “life saving” for suicidal patients who have been failed by other treatments and feel they have nowhere left to turn. The programme, which includes doses of ketamine given intravenously, alongside up to 12 psychotherapy sessions, costs £5,000.
The use of ketamine as a treatment for depression is also currently being considered by at least one Scottish NHS health board.
Ketamine is already licenced across the UK as an anaesthetic and for pain relief. But it is also used illicitly as a recreational drug known as ket or special K, which can cause users to go into a hallucinatory and static state. In 2023 police in England seized record amounts and drug agencies claim it is increasingly popular party drug, particularly with younger users.
Growing research on benefits of ketamine
In recent years there has been growing interest in its potential as a depression treatment. The effects can be short-lived with the impact lasting only a few days initially in some patients, though this can be extended as the treatment continues. The average length of time ketamine is beneficial is 10 days, according to the Oxford Health ketamine service.
Some leading psychiatrists advocating its use have claimed that because it has an immediate impact – unlike antidepressants which can take several weeks to work – it can save lives when used under proper medical supervision.
However, others have raised concerns about using an addictive drug like ketamine for such a vulnerable group, raised worries about side effects, and warned that very careful monitoring and regulation is needed.
Eulas clinic founder John Gillen, told The Ferret he became interested in the use of ketamine and other psychedelics drugs such as psilocybin – the substance found in “magic” mushrooms – while running rehab centres as the director of the private Rehab Clinics Group.
A former alcoholic in long-term recovery, he claimed that better treatments were needed to address issues like underlying trauma which can lead to addictive use of substances.
“I got into all of this because of my own experience,” Gillen told The Ferret, who was a former jockey turned race horse trainer until his “use of alcohol got out of control”.
“I got help,” he added. “But in my view the treatments aren’t good enough. For years I’ve tried to find something else, which led me to an interest in psychedelics.
“Our ketamine programme will be offered to people with depression who have had other treatments – both drug and talking therapies – that have not worked,” “It’s been shown to be really effective for that group.
“This will be private health care though. We would love there to be NHS funding available but that’s not the case so far. Scotland is a sick country and the mental health support on offer is just not enough. This is the future from my point of view.”
We would love there to be NHS funding available but that’s not the case so far. Scotland is a sick country and the mental health support on offer is just not enough.
John Gillen
Other treatments at the clinic include “non drug induced psychedelic state therapy”, which “seeks to induce altered states of consciousness” deep breathing, meditation and hypnosis.
Stroboscopic light therapy, which uses light frequencies “to induce altered states of consciousness similar to those experienced with psychedelic substances” will also be on offer.
The Eulas team is monitoring regulatory developments on the use of psilocybin and traditional medicine ibogaine – a hallucinogenic substance found in the root bark of the West African Iboga shrub –which has been used to treat heroin addiction, with the hope of introducing these if and when they can be legally used.
The Ferret has also learned that NHS Lothian has been researching the potential of ketamine as an alternative to electroconvulsive therapy (ECT) to treat severe depression. A spokesperson said a small number of patients had so far received treatment though “further work needs to be done to develop a full service to deliver this routinely”.
There is growing evidence for its use in this way, though some experts claim both treatments have different merits.
Edinburgh University lecturer Anna Ross, who is currently studying the feasibility of the use of ketamine as a community-based solution for depression and addiction, with the support of the Wellcome Trust, has been monitoring progress at Eulas Clinic.
“The benefits of ketamine seem to be quite significant,” she said. “It can be a highly effective treatment for treatment resistant depression.
“However the delivery of this treatment is going to be very challenging in Scotland because it takes so long to set-up and get the registration in place so you need a company with the money to do that. That prices out anyone looking to offer this as a community-based solution.
“At the moment it is very onerous. Delivery by the NHS is less onerous of course as they don’t require the same set-up costs.”
But she also said she also had some “personal concerns” about the addictive nature of ketamine. Ross, who is the founder of the Scottish Psychedelic Research Group, is an advocate of “plant based medicine” such as psilocybin and claimed that ketamine was being used in its place because it was “legal” but also “cheap and generic”.
Side effect concerns
Fears about the treatment have been raised by some medical professionals who claim that monitoring is critical to ensure people don’t use private clinics without the knowledge and oversight of their NHS clinical team.
Ketamine can have negative side effects and is dangerous if used recreationally on top of supervised doses. Last December an autopsy found Friends actor Matthew Perry, who was undergoing ketamine infusion therapy, drowned when he lost consciousness in his hot tub. The levels of ketamine found in his body were far higher than could be explained by this treatment.
Professor Allan Young, a consultant psychiatrist and leading academic researching mood disorders such as depression at King’s College London, said: “There must be adequate monitoring of its efficacy, of any side effects and regulation and governance to ensure high standards of overall patient care.
“Because ketamine is provided by private clinics and not integrated into the rest of their care there are concerns that there could be doctor shopping, where patients go to one clinic and then another.
“It would ideally be provided in an NHS service but there has been inertia there, I would suspect due to a conservative approach. I am certainly not against this in principle but it does need proper oversight because to be frank, ketamine can be a dangerous drug and this group of patients are very vulnerable.”
A spokesperson for NHS Lothian said: “There has been recent international work that has suggested the use of IV ketamine is a cost-effective alternative to ECT. We’re considering the applicability of this evidence to our local pathways and are planning to submit formal applications through the drug governance processes.
“The introduction of any new service has to be carefully considered, with patient pathways, patient safety, regulatory factors, risk management and overall costs amongst many aspects that must be both worked through and carefully managed.”
A Scottish Government spokesperson said NHS services “locally determine which types of treatment would be most beneficial”. “Decisions on whether to prescribe a medicine are matter for the prescribing clinician in consultation with the patient informed by advice and guidance about the medicine,” they added.
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Cover image thanks to DragonImages/Istock
