AMARILLO, Texas (KVII) — Ketamine therapy is becoming more common in Texas as more patients seek treatment for depression, PTSD, and other mental health conditions, often after other options have failed. Now, proposed rules could tighten oversight of the powerful drug, raising questions about patient safety, access and cost — especially for people in rural areas who rely on telehealth.
Ketamine was originally used as an anesthetic, but it is now used in some settings for mental health treatment. The proposed changes would increase regulation of how ketamine can be provided, including limits on certain at-home use.
Sherif Zaafran, president of the Texas Medical Board, said patients would still be able to access some forms of ketamine at home, including oral and intranasal versions, as long as it is appropriately prescribed.
“Patients at home would still be able to obtain oral ketamine or intranasal ketamine so that that would not affect their ability to obtain that medication in that kind of setting,” Zaafran said. “Whether it’s by telemedicine means, again, appropriately diagnosed, by somebody who can recognize what they’re diagnosing and, and, prescribing it appropriately.”
In Amarillo, Dr. Kathryn McNeil said her clinic monitors patients when providing Spravato, a nasal prescription medication derived from ketamine. McNeil, a psychiatrist, said monitoring is critical, pointing to the risks when substance use issues are not addressed.
“Being monitored is more important,” McNeil said. “You’ve seen cases like Matthew Perry, who had access to paying for the treatment for depression, but had other substance abuse issues that weren’t being monitored and had a terrible outcome. And we have to explain to patients that’s not what we do here. Our doses are regulated because this specific treatment is FDA approved.”
There are also concerns that the proposed rules could increase costs for patients. Zaafran said ketamine treatment is often already paid for out of pocket.
“Ketamine today in that type of setting is already typically not paid by insurance,” Zaafran said. “So it’s already just being paid. Usually has cash pay, even in today’s setting. So we’re banning it in the home and making you know, and well, banning those certain forms at home. You know, yes, there may be an additional cost.”
The Texas Medical Board is scheduled to vote on the proposed changes in June.
Texas considers tighter rules for ketamine therapy as use grows for mental health care (KVII)