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Anesthesiologists' Group Urges Limits on Ketamine Use

Medically reviewed by Carmen Pope, BPharm. Last updated on Feb 12, 2025.

By Ernie Mundell HealthDay Reporter

WEDNESDAY, Feb. 12, 2025 -- The tragic early death of "Friends" star Matthew Perry from a ketamine overdose in 2023 has swung a spotlight on the dangers of unsupervised use of the potent anesthetic.

Now, America's leading group representing anesthesiologists is issuing new guidelines on proper use of the drug.

Ketamine has also come under increasing scrutiny as a treatment recently, with studies suggesting that for some patients it might quickly ease depression.

However, people should never take ketamine without proper dosing and medical supervision, according to new guidelines from the American Society of Anesthesiologists (ASA).

Following Perry's death, there have been "a growing number of false or misleading statements and opinions in the press on its use,” said ASA president Dr. Donald Arnold.

“Ketamine was originally introduced and has its greatest use as an anesthetic," he explained in a society news release. "As anesthesiologists, we felt it was important to increase awareness of how to use it appropriately. People who have struggled with mental health issues and are understandably excited about a new treatment may not realize that they are risking their lives by receiving treatment without medical supervision in unaccredited clinics or offices without established safety standards."

The bottom line, as Perry's case so tragically demonstrated, is that ketamine can have potentially life-threatening effects if used improperly.

These include high blood pressure, slowed breathing, respiratory failure, cardiac issues and seizures.

As the ASA noted, the U.S. Food and Drug Administration (FDA) has never approved ketamine for any use other than anesthesia.

Still, there's been a recent surge in "off-label" use of the infused or injected drug for depression and other purposes.

That's led to the rapid growth of unlicensed in-person clinics or online clinics that supply ketamine by mail, according to the ASA. Patients might be instructed how to administer the ketamine they receive, but any monitoring and guidance stops there.

However, according to the ASA's news release, "Patients should only be prescribed the drug for a medical indication as part of a comprehensive treatment plan, by an appropriately trained and licensed medical professional who monitors the patient with periodic face-to-face visits."

Ketamine, given either via IV drip or injection, should also "only be administered in a monitored setting under the care of a licensed health professional where appropriate rescue equipment is immediately available," according to the ASA guidance.

Other points in the guidance:

• Ketamine should have a clear therapeutic "endpoint" and a defined course of therapy.

• Medical professionals should monitor patients to make sure ketamine is being used properly -- any non-medical uses should not be tolerated.

• Ketamine should only be used at a "minimum dose necessary to achieve a desired clinical effect."

• Patients should be educated about the possible hazards of ketamine use.

• Ketamine doses should never rise to a level where they "produce excessive sedation, unconsciousness or unresponsiveness," unless this is done under the supervision of a licensed medical professional and a safe setting.

“Anesthesiologists are working with psychiatrists via joint research, training programs and other initiatives to advance mental health treatment using these drugs,” the ASA's Arnold concluded.

“People who believe ketamine might be helpful in addressing their mental health issues should talk with their primary care physician or mental health professional,” he added.

Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

© 2025 HealthDay. All rights reserved.

Posted February 2025

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