Ketamine (ketamine hydrochloride) medication treatment is quickly evolving to be an available treatment option for mental health care in Australia, particularly for treatment-resistant or difficult-to-treat depression.
Ketamine has an extensive history in medical treatment, and was first implemented in anaesthesia, and also plays a role in managing chronic pain conditions. Its effects mean that it is used illicitly as a recreational drug.
In Australia, ketamine is available in various forms, including intravenous infusions and nasal sprays. Access to ketamine normally requires a referral from a treating psychiatrist, and ketamine treatment programs include thorough eligibility criteria and assessment, including the risks and benefits of treatment.
In NSW, ketamine is classified as a Schedule 8 controlled medicine, meaning its use is strictly regulated.1 It is illegal to use, possess, supply, or manufacture ketamine without proper authorisation. Exceptions are made for medical practitioners who are authorised to prescribe it for specific medical conditions. On all occasions, medical practitioners must obtain approval from the NSW Ministry of Health to prescribe or supply ketamine, which can be submitted via the SafeScript NSW portal.
In NSW, ketamine medicines are to be administered under direct medical supervision, in a healthcare setting which has established administration and patient monitoring procedures and protocols.
While ketamine treatment for mental health is an emerging treatment and one’s ‘usual practices’ are being contemplated, it would be advisable that detailed guidelines on administration, dosage, monitoring and patient consent is implemented in practice, always, to safeguard against risks to the patient, and medicolegally.
As with all healthcare and treatment, it is ultimately the registered practitioner’s responsibility to comply with best practice protocols and laws.
This article was written by Scott Chapman, Partner and Angela Pale, Special Counsel.
1 Therapeutic Goods (Poisons Standard—February 2025) Instrument 2025.
