Why New Zealand’s Only Ketamine Clinic Is Closing

New Zealand is shutting down the country’s only Ketamine clinic, and patients say Kiwis with chronic depression are losing access to a potentially life-saving drug.

Ketamine, or ‘Special K’ as it’s known on the party circuit, was developed as an anaesthetic, and is commonly used recreationally. In recent years it’s been lauded for its effects on treatment-resistant depression. Professor Ronald Duman, a neurobiologist and psychiatrist at Yale University has called its use “the biggest breakthrough in depression research in half a century”.

Here in New Zealand, the only clinic providing ketamine to mental health patients is in Dunedin. But this week, Southern District Health Board confirmed that they’re ending sponsorship of ketamine trials within their mental health services that they've been running since 2015.

“Unfortunately we haven't seen the effectiveness we were hoping for with an efficacy rate of around 20 percent,” Southern DHB Medical Director Dr Brad Strong said in a statement. “Our experience echoes international research in this emerging field that casts substantial doubt on the current practice of extended use of ketamine for those with treatment-resistant depression.”

He goes on: “Ketamine continues to be the source of much hope across the world for people with treatment resistant depression and many other mental health disorders. What we've discovered is that for long term treatment, it doesn't seem to work very well.

Student Jemima Lomax-Sawyers, 23, was a member of the ketamine treatment clinic. She says after dozens of other treatments that didn’t work, ketamine helped save her life.

“For many of us, ketamine was our last chance, our only chance for living a life out of hospital, or even for living full stop,” she says. Before she began treatment, Lomax-Sawyers had treatment-resistant depression, was chronically suicidal, experiencing psychotic episodes, and had made several attempts to take her own life. A combination of ECT and ketamine infusions helped her recover and, she says, start living her life.

“The DHB says only 20 percent of its patients benefited from ketamine. But 20 percent isn’t terrible considering people like myself are on it after having tried literally everything else.”

READ MORE: Ketamine Saved My Life. Now NZ’s Only Treatment Clinic is Shutting Down

Dr Suresh Muthukumaraswamy is involved with University of Auckland’s own clinical trials of ketamine, which are focused on how the drug works in the brain.

“There is extensive clinical trial evidence showing that it works,” he says.

Internationally, Muthukumaraswamy says studies put the Ketamine’s efficacy for treating depression at 60-70 percent—a high success rate for the treatment–resistant patients whom the drug tends to be trialled with. He says the Auckland clinical study has been running for around a year, and also has an efficacy rate of around 60 percent. Their trials involve patients who have already experienced two treatment failures.

Southern DHB has reported a success rate of 20 percent, which is lower than many other studies, but could be the result of more treatment-resistant patients.

“A lot of it’s to do with which patients you select …. if you select patients that are less resistant—and this is true of any antidepressant trials—less resistant patients are more likely to respond to a treatment. So the 60 percent is from standard trials, but with particularly difficult patients, then the efficacy rate will be lower.”

Lomax-Sawyers says for patients who have experienced recovery with the treatment, it’s terrifying to learn it may become inaccessible.

“While [the DHB is] doing this, we are waiting very anxiously to hear if we will have to go back to suffering, to not being able to get out of bed, to waking up in the morning and wishing we hadn’t. Because these are the lives we used to live—the life I used to live—and if you get rid of the programme, that is what some of us face returning to.”

Dr Strong said the DHB was continuing to support patients who have received, or are currently receiving ketamine treatment. He said patients would be contacted to review their treatment plans, and “ketamine treatment will continue until such time as a further treatment plan can be agreed.”

He said there were “some patients who have experienced positive outcomes from this treatment, and we are pleased they have been able to experience relief from their conditions. But those examples are too few and sporadic for us to continue our sponsorship of these clinical trials.”

According to Southern DHB, there are currently seven patients under treatment at the clinic and nine on the waiting list.

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