TL;DR
Get workout gear delivered free with Prime
- Fast, free delivery on millions of items
- Prime Video, Amazon Music and more included
- Member-only deals all year
A MedPage Today opinion article published Oct. 11 argues that ketamine’s expanding use is not matched by consistent safety standards, particularly for off-label prescribing. The authors cite the pending investigation into Presley Gerber’s death, but his official cause of death has not been released and the circumstances remain under investigation.
Three psychiatrists are calling for clearer safety standards for ketamine prescribing, arguing in an Oct. 11 MedPage Today opinion article that safeguards vary widely for off-label treatment. The authors point to reports that a doctor prescribed ketamine to model Presley Gerber, who had a public history of addiction; Gerber’s death is being investigated as a suspected overdose, and his official cause of death is pending.
The article was written by psychiatrists Tucker Avra, Renée Sorrentino and Fernando Espi Forcen, who say clinicians should assess addiction risk and document the reasoning behind treatment decisions. They argue that a known substance-use history calls for careful risk-benefit consideration, not an automatic prescription or a decision based on a patient’s status or preference.
Ketamine was approved in 1970 as an anesthetic. The Food and Drug Administration approved esketamine, sold as Spravato, for treatment-resistant depression in 2019; it is subject to a Risk Evaluation and Mitigation Strategy, or REMS. Ketamine itself is also prescribed off-label for conditions including depression, post-traumatic stress disorder and obsessive-compulsive disorder, but the authors say that use does not have a comparable mandatory safety program.
The authors distinguish supervised clinic-based courses from patterns of chronic use. They say research and their clinical experience suggest ketamine use disorder is uncommon in controlled, in-person depression clinics, while warning that the effects and risks of longer-term use remain poorly understood. Their examples of potential safety failures include at-home treatment without adequate supervision, insufficient monitoring during injections or infusions, online prescribing without in-person assessment, and inadequate informed consent.
Safeguards Vary Across Ketamine Care
The debate matters because ketamine is used in legitimate mental-health care while its prescribing settings and oversight differ. A patient may receive esketamine under a required federal safety program, or ketamine off-label in a setting without an equivalent national requirement. The authors argue that such variation can leave assessment of addiction history and other risks dependent on the individual prescriber.
The article also describes a growing commercial market and expansion of clinics and telehealth services. The authors cite a U.S. ketamine market valued at more than $5 billion and projected to exceed $14 billion by 2035. Market growth does not itself establish unsafe care, but the authors say it sharpens the need for standards that keep pace with access and clarify professional responsibilities.
For patients, the practical concern is whether treatment includes appropriate screening, supervision, monitoring and informed consent. For clinicians and providers, inconsistent expectations can create patient-safety and liability risks. The article is an argument for stronger standards, not a finding that any specific provider violated a standard of care.
As an affiliate, we earn on qualifying purchases.
From Approved Esketamine to Off-Label Use
Ketamine’s medical history includes its use as an anesthetic, while esketamine has a separate FDA approval for treatment-resistant depression and is dispensed under REMS requirements. That distinction matters: the article discusses ketamine’s broader off-label prescribing, not a change to the FDA approval or safety rules for Spravato.
The authors also refer to Matthew Perry’s death as a cautionary comparison. Perry’s autopsy identified acute ketamine effects as a contributing factor; the article says the fatal dose came from another source, while a doctor who had prescribed ketamine to him later pleaded guilty to distributing the drug without a legitimate medical purpose. Gerber’s case is at a different stage: the investigation continues and his cause of death has not been officially determined.
The authors cite American Psychiatric Association guidance and the Spravato label as supporting careful assessment when a patient has a substance-use history. They also report that the number of people starting treatment for ketamine addiction in the United Kingdom rose more than eightfold over the past decade. That figure concerns treatment starts there; it does not establish the prevalence of addiction among ketamine patients in the United States.
“The answer must be a clear, evidence-based response that acknowledges ketamine’s efficacy while balancing the risk to patients.”
— The three authors
Gerber Cause and Standards Remain Unsettled
Gerber’s official cause of death is pending. The source says the death is being investigated as a suspected overdose and relays friends’ statements that a doctor prescribed ketamine for months despite awareness of addiction struggles. Those accounts are allegations and do not establish the cause of death or a legal or professional finding about the prescriber.
The article does not set out a finalized, universally enforced standard for every ketamine clinic or telehealth provider. It also says the effects of chronic ketamine use are largely unknown and that ketamine addiction remains poorly defined in psychiatric guidelines. The authors’ proposals are advocacy in an opinion article, not a regulatory decision or a new clinical guideline.
Calls for Oversight and Case Findings
The next confirmed development in Gerber’s case is the release of investigative findings, including an official cause of death; the source provides no timetable. Until then, claims about the circumstances should remain distinct from established findings.
On prescribing policy, the authors urge clearer, evidence-based standards, stronger oversight of at-home ketamine delivery and greater provider oversight in clinics. The source does not report that a new rule has been adopted or give a date for regulatory action. For now, the central question is whether professional and regulatory bodies will translate calls for consistent screening, monitoring and documentation into enforceable requirements.
Key Questions
What is the news development?
Three psychiatrists published an opinion article calling for clearer safety standards for ketamine prescribing, especially off-label use and care delivered outside supervised clinics.
Has Presley Gerber’s cause of death been determined?
No. The source says his death is being investigated as a suspected overdose, but his official cause of death remains pending.
Is ketamine the same as Spravato?
No. Spravato is esketamine, a specific form of ketamine approved by the FDA for treatment-resistant depression and subject to a REMS safety program. The article says off-label ketamine prescribing lacks a comparable mandatory program.
What safeguards do the authors say should be used?
They call for careful assessment of substance-use history, documented risk-benefit decisions, appropriate monitoring and informed consent. They also support stronger oversight of at-home treatment and clinic providers.
Source: rss
Halloween Picks
halloween
As an affiliate, we earn on qualifying purchases.
