• Posted September 5, 2024

Ketamine Can Fight Depression, But Pregnant Women Face Risks

Ketamine is becoming a popular depression drug, but doctors aren’t keeping in mind the danger it can pose to a pregnancy, a new study warns.

Ketamine can be very harmful to a developing fetus and should not be used during pregnancy, researchers said.

But only 20% of ketamine clinics require a pregnancy test at least once prior to or during treatment, according to results published recently in the Journal of Clinical Psychiatry.

Further, only 26% of clinics discuss the potential need for contraception with ketamine patients, and fewer than 15% specifically recommend or require contraception use during ketamine treatment, researchers found.

That is concerning because more than 80% of clinics prescribe long-term maintenance ketamine, with nearly 70% saying patients receive care for more than six months.

“These data suggest that a large population of patients could be pregnant, or could become pregnant, while receiving ketamine treatment,” said lead researcher Dr. Rachel Pacilio, a clinical assistant professor of psychiatry at the University of Michigan. 

“Many patients do not know that they’re pregnant in the first weeks, and animal studies of ketamine are very concerning for potential harm to the fetus during this time,” Pacilio added in a university news release.

Ketamine is administered to people with depression as an IV drip or through a nasal spray. It works differently from standard antidepressants, according to the Mayo Clinic, by promoting more connections between brain cells.

But in lab studies, ketamine caused damage to the developing brains of fetal rats and monkeys, according to American Addiction Centers.

To see whether ketamine clinics are taking these concerns seriously, researchers surveyed 119 centers across the United States treating more than 7,000 people with ketamine. About a third of those patients are women in their childbearing years.

More than 75% of the clinics said they had a formal pregnancy screening process, but only 1 in 5 required a pregnancy test.

More than 90% also said that they tell patients in documents or conversations that ketamine shouldn’t be taken while pregnant, results show.

However, less than half said they discuss specific potential risks of ketamine use in pregnancy with patients, the researchers added.

Examining consent documents on the websites of 70 ketamine centers, researchers found that 39% did not include language about pregnancy in their paperwork. Those that do mention pregnancy are generally vague.

“The variability in practice that we see among clinics in the community in this study is stark,” Pacilio said. “The field is really in need of standardization around reproductive counseling, pregnancy testing and the recommendation for contraception during ketamine treatment.”

After sharing these findings with University of Michigan Health, the institution’s ketamine clinic began recommending the use of highly reliable contraceptives to patients who could become pregnant while on the drug, Pacilio said.

“Ketamine is a really effective, potentially lifesaving, treatment for the right patients, but not everyone is a good candidate for it,” she said. “As psychiatrists, we need to ensure this treatment is being delivered in a way that benefits patients while preventing harm.”

More information

The Mayo Clinic has more about ketamine for depression.

SOURCE: University of Michigan, news release, Aug. 26, 2024