Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia; and Australian Research Council Centre of Excellence for Children and Families over the Life Course, Australia
Jason Kawalsky
Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia
Alyssa Milton
Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia; and Australian Research Council Centre of Excellence for Children and Families over the Life Course, Australia
Christiane Klinner
Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia; and Australian Research Council Centre of Excellence for Children and Families over the Life Course, Australia
Aaron Schokman
Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia; and Australian Research Council Centre of Excellence for Children and Families over the Life Course, Australia
Elizabeth Stratton
Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia; and Australian Research Council Centre of Excellence for Children and Families over the Life Course, Australia
Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia; Australian Research Council Centre of Excellence for Children and Families over the Life Course, Australia; and Professor Marie Bashir Centre, Royal Prince Alfred Hospital, Australia
Background Public and patient expectations of treatment influence health behaviours and decision-making. Aims We aimed to understand how the media has portrayed the therapeutic use of ketamine in psychiatry. Method We systematically searched electronic databases for print and online news articles about ketamine for psychiatric disorders. The top ten UK, USA, Canadian and Australian newspapers by circulation and any trade and consumer magazines indexed in the databases were searched from 2015 to 2020. Article content was quantitatively coded with a framework encompassing treatment indication, descriptions of prior use, references to research, benefits and harms, treatment access and process, patient and professional testimony, tone and factual basis. Results We found 119 articles, peaking in March 2019 when the United States Food and Drug Administration approved esketamine. Ketamine treatment was portrayed in an extremely positive light (n = 82, 68.9%), with significant contributions of positive testimony from key opinion leaders (e.g. clinicians). Positive research results and ketamine's rapid antidepressant effect (n = 87, 73.1%) were frequently emphasised, with little reference to longer-term safety and efficacy. Side-effects were frequently reported (n = 96, 80.7%), predominantly ketamine's acute psychotomimetic effects and the potential for addiction and misuse, and rarely cardiovascular and bladder effects. Not infrequently, key opinion leaders were quoted as being overly optimistic compared with the existing evidence base. Conclusions Information pertinent to patient help-seeking and treatment expectations is being communicated through the media and supported by key opinion leaders, although some quotes go well beyond the evidence base. Clinicians should be aware of this and may need to address their patients’ beliefs directly.
