Academic Journal
Interdisciplinary, Delphi-driven consensus guidelines on the use of intravenous ketamine infusions for depressive disorders from the American Society of Ketamine Physicians, Psychotherapists, and Practitioners (ASKP3).
| Τίτλος: | Interdisciplinary, Delphi-driven consensus guidelines on the use of intravenous ketamine infusions for depressive disorders from the American Society of Ketamine Physicians, Psychotherapists, and Practitioners (ASKP3). |
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| Συγγραφείς: | Mathai DS; Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Sattva Medicine, Psychiatry and Psychotherapy Practice, Miami, FL, USA. Electronic address: dmathai@bcm.edu., Cluck M; Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA., Aslam AM; Radial, New York City, USA., Amato E; Montana Psychiatry and Brain Health Center, Billings, MT, USA., Azam A; Daydream MD, San Diego, CA, USA., Banov M; Psych Atlanta/Hightop Health, Marietta, GA, USA; Department of Psychiatry, Medical College of Georgia, Augusta, GA, USA., Barrett KA; ASKP3 Strategist, Denver, CO, USA., Bonnett CJ; Klarisana, Denver, CO, USA., Feifel D; Kadima Neuropsychiatry Institute, La Jolla, CA, USA; University of California San Diego, La Jolla, CA, USA., Grundmann N; Ember Health, New York City, NY, USA., Ko HS; Reset Ketamine, Palm Springs, CA, USA., McShane R; Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK., Prashad S; Houston Center for Advanced Psychiatric Treatment, Houston, TX, USA., Santini T; BrainStim Health, Vancouver, BC, Canada; California Southern University, Irvine, CA, USA., Stewart LH; Nordre Østfold District Psychiatric Senter, Østfold Hospital Trust, Grålum, Norway; Axon Clinic, Oslo, Norway., Sullivan P; Initia Medical Solutions, Cherry Hill, NJ, USA., Wolfsohn SD; Ventura Center for Advanced Therapeutics, Camarillo, CA, USA., Robinson JO; Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA., McGuire AL; Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA., McInnes LA; Mindful Health Solutions, Oakland, CA, USA. |
| Πηγή: | Journal of affective disorders [J Affect Disord] 2026 Oct 15; Vol. 411, pp. 121970. Date of Electronic Publication: 2026 May 16. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Netherlands NLM ID: 7906073 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2517 (Electronic) Linking ISSN: 01650327 NLM ISO Abbreviation: J Affect Disord Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press. |
| Ιατρικοί όροι (MeSH): | Ketamine*/administration & dosage , Ketamine*/therapeutic use , Depressive Disorder*/drug therapy , Antidepressive Agents*/administration & dosage , Antidepressive Agents*/therapeutic use , Practice Guidelines as Topic*, Humans ; Delphi Technique ; Consensus ; Infusions, Intravenous ; United States ; Psychotherapists ; Off-Label Use ; Societies, Medical |
| Περίληψη: | Background: Off-label use of intravenous ketamine (IVK) for depression is a widespread practice with limited regulation in the United States. There is an urgent need for current, evidence-informed treatment guidelines to facilitate patient safety, clinical decision-making, and care quality in real-world contexts. Methods: The American Society of Ketamine Physicians, Psychotherapists and Practitioners (ASKP3) convened an interdisciplinary working committee tasked with creating guidelines for use of IVK for depression in outpatient settings. Guideline development followed a two-stage process: 1) a hybrid systematic and targeted evidence review and preliminary drafting by the committee, and 2) consensus refinement through a modified Delphi method using a panel composed of the committee and ASKP3 expert faculty. Panelists rated their agreement with proposed guideline items using a 9-point Likert scale, and consensus was predefined as a median rating ≥ 7 with an interquartile range ≤ 2 after Round 2. Consensus strength was evaluated using percentage agreement thresholds. Results: Of 39 invited experts, 28 completed at least one round of the survey. Consensus was achieved on 73 of 75 of proposed guideline items (97%), with most items reaching very strong consensus (i.e., ≥90% of panelists rating a statement within the 7-9 range). Guideline items were organized across seven key practice areas. Conclusions: By combining a hybrid literature review and Delphi process, we developed expert consensus recommendations for the safe and effective use of IVK for depression. These guidelines can support decision-making, standardize clinical practice, improve patient outcomes, and promote equitable access to this emerging treatment, while informing ongoing research and policy development. (Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: DSM is owner of Sattva Medicine and has received consulting fees from ASKP3 for work related to this study and Beckley Clinical. AMA is an employee at Radial. EA is owner of Montana Psychiatry and Brain Health Center, serves as a speaker for Johnson & Johnson, and is a stockholder in Turnwell Mental Health, Inc. AA is owner of Daydream MD. MB is owner of Psych Atlanta/Hightop Health. KAB is a paid consultant with ASKP3. CJB is owner of Klarisana. DF is owner of Kadima Neuropsychiatric Institute and serves as a consultant for AtaiBeckley, Helus, and Otsuka. NG is owner of Ember Health. HSK is owner of Reset Ketamine. RMcS runs a ketamine clinic on behalf of his employer Oxford Health NHS Foundation Trust. SP is owner of Houston Center for Advanced Psychiatric Treatment. TS is an employee at BrainStim Health. LHS is an owner of Axon Clinic. PS is owner of Initia Nova Medical Solutions. SDW is owner of Ventura Center for Advanced Therapeutics. LAM is an employee at Mindful Health Solutions and serves on the Scientific Advisory Board for Osmind. DSM, AMA, EA, AA, MB, CB, DF, NG, HSK, RMcS, SP, TS, LHS, PS, SDW, and LAM all serve as volunteer faculty with ASKP3. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. |
| Contributed Indexing: | Keywords: Delphi; Depression; Guidelines; IV ketamine; Psychiatry; Racemic ketamine |
| Substance Nomenclature: | 690G0D6V8H (Ketamine) 0 (Antidepressive Agents) |
| Entry Date(s): | Date Created: 20260517 Date Completed: 20260611 Latest Revision: 20260611 |
| Update Code: | 20260611 |
| DOI: | 10.1016/j.jad.2026.121970 |
| PMID: | 42144140 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1573-2517 |
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| DOI: | 10.1016/j.jad.2026.121970 |