Hospital investigated for ketamine

Ketamine. Photo / NZ Herald

Dunedin Hospital is under investigation over the use of drugs in medical research without proper patient permission.

The National Health Board yesterday released terms of reference to examine the use of ketamine in Dunedin Hospital's mental-health service.

Ketamine is commonly used as a horse tranquilizer, and on the party drug scene is known as "Special K".

The Health Board review will determine whether patients prescribed ketamine "could be considered to have been participating as research subjects without having been so advised or having given their consent".

Included in the investigations would be scrutiny of hospital processes on "off-label" prescribing, a use not specifically approved.

The Health and Disability Commissioner began an investigation this month after earlier rejecting a complaint from a Dunedin mental-health trust about Professor Paul Glue's prescribing of ketamine.

Professor Glue is a hospital psychiatrist and head of psychological medicine at the Dunedin School of Medicine.

In April, commissioner Anthony Hill, responding to Otago Mental Health Support Trust advocate Mike McAlevey, said patients were given information about the risks, side effects and benefits of ketamine in treatment-resistant depression.

They were assessed as able to give consent, and none was subject to compulsory mental-health treatment orders.

Although deciding to take no further action, Mr Hill told Professor Glue and the Southern District Health Board it needed to be made clear the drug was being used "off-label".

DHB (Otago) chief medical officer Richard Bunton said the DHB was satisfied Prof Glue had followed correct protocol.

"We felt there had been no misuse of the drug at all."

Mr McAlevey said an abstract from a presentation Prof Glue gave at a conference last October had the appearance of "organised research".

Fast acting antidepressants: Past, present, and future prospects for ketamine summarises the results of "local experience" of treating 10 adults with "treatment-resistant major depression" using an intramuscular injection of ketamine.

A spokeswoman for Otago University said a response issued to the ODT on Prof Glue's behalf last November, which said ketamine prescribing was not a "formal research study", still stood.

In the response, Prof Glue wrote that patients provided informed consent and although it was an off-label use of ketamine, its use was supported by clinical trial data and it was found to be safe and well tolerated.