Grave Warning: Dr. Melané van Zyl Addresses Ketamine Misuse Amid a Worsening Mental Health Climate
Ketamine & Ketamine Therapy: From Critical Intervention to Public Hazard
Within South Africa’s evolving mental health landscape, clinicians are raising a serious alert about the unregulated use of ketamine, a potent NMDA receptor antagonist with substantial anesthetic properties. Dr. Melané van Zyl, a leading psychiatrist and spokesperson for the South African Society of Psychiatrists (SASOP), appeared on Newzroom Afrika (DStv Channel 405) to emphasize the ethical and clinical responsibilities linked to ketamine use. “Ketamine is neither a recreational pastime nor a quick solution to mental health challenges,” she states, underscoring the delicate balance between its therapeutic promise and potential for harm when administered without professional oversight.
In a formal medical setting—such as a hospital or a specialist clinic—ketamine has demonstrated efficacy in treating severe depression, particularly in patients with treatment-resistant depression (TRD). Its rapid-acting nature can help manage acute suicidal ideation, instilling hope in individuals who have not responded to more conventional interventions. Nevertheless, Dr. van Zyl has observed that unsupervised or irresponsible administration of ketamine significantly heightens the risk of adverse effects, including cognitive impairment, psychological destabilization, and in some instances, mortality. “Ketamine can be life-altering when administered correctly,” she explains, “but it becomes a serious liability when providers lack the requisite psychiatric and anesthetic expertise.”
Despite clearly defined protocols issued by SASOP and the South African Society of Anaesthesiologists (SASA), private clinics and non-credentialed providers continue to flout established guidelines. Ketamine’s psychotropic effects, coupled with its potential for dependence, have drawn the attention of profit-driven practitioners and unauthorized distribution networks. According to Dr. van Zyl, “We are already grappling with unprecedented mental health pressures. Adding uncontrolled ketamine use only compounds the challenges, placing individuals at a profound risk of medical and psychological harm.”
SASOP’s Zero-Tolerance Policy
In an unambiguous stance against these infringements, SASOP and SASA collectively stress three fundamental principles:
• TRD Necessitates Psychiatric Supervision: Accurate diagnosis and long-term care for treatment-resistant depression must remain under the jurisdiction of psychiatrists. General practitioners or psychologists prescribing ketamine for TRD not only breach professional conduct but also endanger patient outcomes through possible misdiagnosis and insufficient follow-up.
• Mandatory Anesthetic Oversight: Intravenous (IV) ketamine must be administered strictly under the guidance of an anesthetist or a general practitioner with anesthesia training, in a facility adequately equipped to manage acute complications. This environment ensures rapid intervention in the event of anesthesia-related risks, such as circulatory collapse or severe psychological reactions.
• No Tolerance for Illegal Psychedelics: Psychedelic substances like psilocybin and MDMA remain criminalized in South Africa. SASOP’s directive leaves no ambiguity: unauthorized promotion or use of these compounds can lead to legal penalties and possible professional sanctions.
As Dr. van Zyl elaborates, “Clinics advertising unverified ketamine treatments on social media or bypassing medical protocols exploit a susceptible population. They routinely skip comprehensive psychiatric evaluations, neglect adequate follow-up care, and monetize patient desperation without ensuring clinical safety. Such conduct contradicts every principle of legitimate mental healthcare.”
Confronting the “Ketamine Cowboy” Phenomenon
The surge in private practices touting ketamine as a universal remedy warrants elevated scrutiny. Encouraged by exaggerated claims of immediate relief, vulnerable individuals often seek quick fixes, inadvertently subjecting themselves to substandard care. SASOP identifies several troubling trends:
• Misclassification of Patients: Some individuals are labeled as having TRD with insufficient diagnostic rigor, leading to inappropriate ketamine administration.
• Deficient Continuity of Care: While patients may briefly benefit from ketamine’s mood-elevating effects, they receive no comprehensive plan for ongoing psychiatric or psychological intervention, increasing their susceptibility to relapse.
• Regulatory Infractions: Clinics flouting South African Health Products Regulatory Authority (SAHPRA) rules by promoting off-label ketamine use prioritize revenue over patient safety, a practice that amounts to malpractice.
“Operating outside of SASOP/SASA guidelines is not just negligent but also morally indefensible,” Dr. van Zyl maintains. “Those engaged in these practices jeopardize their patients’ well-being and expose themselves to significant litigation.” Healthcare stakeholders and patient advocacy groups are pushing for enhanced supervision and clearer regulatory enforcement to curb harmful practices.
A Clear Directive: Comply or Face Consequences
SASOP and SASA insist on immediate adherence to their recommendations:
• Psychiatrists must supervise the assessment, diagnosis, and referral pathway for TRD. Their specialized expertise is instrumental in determining whether ketamine is indeed appropriate and in monitoring for possible contraindications.
• Anesthetists must oversee the administration of IV ketamine. No exceptions are permissible, given the complexity and potential hazards of ketamine’s pharmacokinetics.
• Any involvement with illicit psychedelics must be reported to the proper authorities. Failing to do so can undermine public health efforts and lead to disciplinary action.
“There is no room for misinterpretation,” Dr. van Zyl concludes. “Patient safety is at the core of our profession. Those who ignore these directives invite grave legal and ethical repercussions.” Given the severe mental health challenges faced by many South Africans, upholding rigorous treatment standards is a moral imperative.
Watch the Complete Ketamine Video Interview
For a detailed exploration of ketamine’s benefits, its associated risks, and the standards advocated by SASOP, viewers are encouraged to watch Dr. van Zyl’s interview on Newzroom Afrika (DStv Channel 405) below. Her insights illuminate the delicate interplay between administering ketamine responsibly and the dangers posed by unregulated usage.
Key Takeaway: Place Safety Above Profit
Dr. van Zyl’s overarching message, while firm, carries a note of empathy: “Individuals considering ketamine therapy must confirm a psychiatrist’s involvement and ensure compliance with SASA guidelines. The well-being of patients and their families should always surpass commercial considerations.” She stresses that it is equally crucial for loved ones and caretakers to remain vigilant, posing essential inquiries about training, emergency protocols, and consistency in mental health follow-up.
About Dr. Melané van Zyl:
A respected psychiatrist and SASOP spokesperson, Dr. van Zyl champions evidence-based mental health treatments across South Africa. Her extensive engagements involve policy advisement, interdisciplinary research, and education, emphasizing the ethical and clinical rigors of ketamine therapy for high-risk patients.
Disclaimer: This public health bulletin is intended for informational purposes only. Individuals interested in ketamine treatment should always consult a qualified psychiatrist. Although new interventions can offer hope, adherence to accredited guidelines is indispensable for ensuring safe and ethical clinical practice.
CREDITS
Medical practitioners are sending a stern warning over the unsupervised use of the anesthetic drug Ketamine. It is used to induce a loss of consciousness and relieve pain, and can bring life-saving hope for people suffering from major depression or at severe risk of suicide. SA Society of Psychiatrists’ Dr Melané van Zyl has more.
Tune into Newzroom Afrika DStv channel 405 for more.
Dr. Melané van Zyl, spokesperson for the South African Society of Psychiatrists (SASOP), delivers a stern warning against the unsupervised use of ketamine, emphasizing its grave risks when misused recreationally or administered irresponsibly in unregulated clinics. In a Newzroom Afrika (DStv 405) interview, she stresses that ketamine—though lifesaving for treatment-resistant depression (TRD) under strict protocols—is being dangerously exploited. SASOP and the South African Society of Anaesthesiologists (SASA) mandate that TRD must be diagnosed exclusively by psychiatrists, with ketamine administered only by anesthetists in controlled settings. The article condemns illegal psychedelics (e.g., psilocybin, MDMA) and unregulated clinics bypassing safety guidelines, urging compliance to avoid legal repercussions and protect patient lives.