Circulated for consultation—Parenteral Use of Ketamine for the Treatment of Mood Disorders

In the September/October 2020 College Connector, registrants were advised that ketamine for the treatment of a major depressive disorder administered by any route in the community setting must be performed in an accredited non-hospital facility under the order of a treating psychiatrist.

The College subsequently published a clarification on the requirements for intranasal esketamine stating that psychiatrists may prescribe SPRAVATO® to patients who meet the appropriate criteria in a community setting, as long as they have appropriate training and knowledge and are doing so in accordance with the requirements set out by Health Canada and the SPRAVATO® Canadian product monograph. The clarification further advised that off-label parenteral administration of ketamine for depression continues to only be permitted in accredited non-hospital facilities.

The draft NHMSFAP accreditation standard Parenteral Use of Ketamine for the Treatment of Mood Disorders has been developed and circulated for consultation. Registrants are invited to provide feedback via a brief survey by February 17, 2021. Ketamine administration for the treatment of mood disorders such as major depressive disorder (MDD) by intravenous (IV), intramuscular (IM), and subcutaneous (SC) routes must be performed in an accredited non-hospital facility.

This draft standard does not apply to intranasal esketamine (SPRAVATO®) administered in a non-accredited facility (e.g. physician office/clinic).