Mapping consent practices for outpatient psychiatric use of ketamine

David S. Mathai, Scott M. Lee, Victoria Mora, Kelley C. O'Donnell, Albert Garcia-Romeu, Eric A. Storch

Research output: Contribution to journalArticlepeer-review


Background: Given increasing community-based and off-label use of ketamine for psychiatric indications, we examined current informed consent processes from a convenience sample of outpatient ketamine clinics to identify areas of congruence with current evidence and opportunities for growth. Methods: Using a rubric developed from existing practice guidelines, we conducted an exploratory analysis of informed consent documents (IC-Docs) from 23 American clinics offering ketamine as a psychiatric treatment. Domains assessed included clinical content, procedures, and syntax. Results: Participating clinics (23/288) varied widely in their constitution, training, and services provided. We found that IC-Docs addressed a majority of consent elements, though did so variably on an item-level. Areas for improvement included communication around long-term adverse effects, treatment alternatives, medical/psychiatric evaluation prior to treatment, medical/psychological support during treatment, adjunctive psychological interventions, and subjective/dissociative-type effects. All forms were limited by poor readability. Limitations. Our study was limited by convenience sampling along with possible underestimation of verbal consent processes. Conclusions: As ketamine continues to emerge as a psychiatric intervention, both patients and providers will benefit from a deliberate consent process informed by scientific, ethical, and pragmatic factors toward the goal of shared decision-making regarding treatment.

Original languageEnglish (US)
Pages (from-to)113-121
Number of pages9
JournalJournal of Affective Disorders
StatePublished - Sep 1 2022


  • Consent
  • Depression
  • Ethics
  • Ketamine
  • Off-label
  • Psychedelics

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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