Parents are highly accepting of adolescents’ use of ketamine therapy to treat suicidality, major depressive disorder, and bipolar disorder, according to a new survey. 

The study, published in the Journal of Child and Adolescent Psychopharmacology, examined parental attitudes towards ketamine as a treatment for adolescent mood disorders and suicidality. This first-of-its-kind research is significant in the context of parents’ critical role in consenting to ketamine treatment for their children.  

Sadly, an estimated 14.3% of United States adolescents have a mood disorder, according to the National Institute of Mental Health. In 11.2% of these cases, the mood disorder causes severe impairment. While not currently approved for adolescent psychiatric use, ketamine has demonstrated rapid but temporary antidepressant effects when used for treatment-resistant mood disorders.

“Ketamine has gained popularity as a mechanistically novel, rapid-acting, and ultimately hopeful intervention for treatment-resistant depression and suicidality in adults,” the study authors explained. “As parents maintain decision-making capacity of their child’s medical care, parental consent is a key factor in the adoption of new treatments for adolescents.”

Parents were asked to complete a survey that included questions on the psychiatric use of ketamine, acceptability, and their perceptions of ketamine treatment. It found parents reported high acceptability of ketamine, with a median response of 7/10 for its use in treating suicidality, major depressive disorder, and bipolar disorder. “Ketamine acceptability for suicidality was greater than that for bipolar disorder and major depressive disorder … indicating greater openness to novel treatments for adolescent suicidality,” the authors said.

The survey also showed parents preferred short-term applications and less invasive routes of administration for ketamine, with nasal spray the preferred administration method, followed by oral or sublingual administration. However, 66% of respondents said they would be willing to try one to two doses of ketamine in an emergency center for suicidal adults.

Parents with a history of mental illness, familiarity with psychological treatments, and those who were comfortable using other mental health interventions in their children also showed greater acceptability of ketamine therapy.

The primary concerns of parents were the possible side-effects of ketamine, the lack of United States Food and Drug Administration (FDA) approval for the psychiatric use of ketamine in children outside of research protocols, abuse potential, age of the child, and the child’s capacity to make their own treatment decisions.

“Although there is accumulating evidence for the efficacy, safety, and tolerability of ketamine in younger populations, these remain open inquiries and are reflected in concerns reported here,” the authors said.

They concluded that because ketamine was still in the experimental stage for children, further research was needed. “Our study provides orientation for further investigation and dissemination of knowledge around parental attitudes towards ketamine — an innovative and emerging treatment for adolescent mental health,” the authors concluded.

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