The Misplaced Fear Around Ketamine Therapy for Adolescents
*Op-Ed Submitted to USA Today
Key Takeaways
Adolescent depression affects 8–20% of teens, with up to 40% resistant to standard treatments.
Conventional options like SSRIs are slow to act and carry safety concerns, including increased suicidal risk.
Ketamine can reduce depressive and suicidal symptoms within 24 hours, with relief lasting up to two weeks.
Clinical evidence and systematic reviews show ketamine is generally safe and well tolerated by teens.
Outcomes are best when ketamine is paired with therapy and family systems work, not offered in isolation.
Fear around ketamine stems from stigma and sensationalized headlines, not evidence.
Responsible adoption requires standards of practice, training, and oversight to protect adolescents.
More research, education, and policy clarity are essential to distinguish legitimate therapeutic use from opportunistic misuse.
A recent USA Today article, “Parents are quietly trying ketamine therapy for their teens. It's highly controversial,” sounded the alarm on ketamine therapy for adolescents. Fear sensationalizes, but without context it’s reckless. The evidence tells a very different story.
Adolescent mental health is an epidemic. Major depressive disorder affects about 8 percent of teens, and up to 20 percent will experience an episode by adulthood. Suicide is now a leading cause of death in young people. Even with treatment, up to 40 percent remain resistant. Conventional options like SSRIs and talk therapy can take months to work. That delay is dangerous for teens in crisis. SSRIs carry an FDA black box warning for those under 25, with evidence they can increase suicidal risk early in treatment. Are conventional therapies really working, and can we put our kids at risk waiting for them to work?
Ketamine changes the equation. A single low-dose infusion has been shown to cut depressive and suicidal symptoms within 24 hours, with relief lasting up to two weeks. In a larger trial, repeated low-dose esketamine treatments reduced depression in adolescents. Systematic reviews show consistent benefits and no serious adverse events. Most teens tolerate ketamine well, with only mild, short-lived effects.
I have been working with ketamine for six years. Parents seek me after exhausting standard therapies. They don’t want another “set it and forget it” prescription. They want relief and a path forward. My professional cutoff is age 14, but psychological age matters more than biological age. Teens with maturity, language, and life experience integrate discoveries from ketamine, especially when supported by therapy and family systems work. The best outcomes come when parents do their own work so the child isn’t carrying their unhealed pain.
I’ve sat with teens struggling with suicidal thoughts. Without ketamine, the next options are hospitalization, a 72-hour hold, or worse. Instead, we initiated treatment that preserved autonomy and dignity. Suicidal thinking lifted. Therapy continued. Parents saw their child emerge again with a sense of hope in the world. But ketamine is not always the right choice for every teen. Teens lacking psychological maturity or supportive families are not ready. In those cases, the safer path is conventional therapy and educating the family system.
Critics argue we don’t know what ketamine does to the adolescent brain. That fear has no merit. No studies show permanent brain changes from therapeutic ketamine in teens or adults. But, depression does change the brain. Chronic stress alters neural pathways, damages biological systems, and distorts how adolescents see themselves and the world. A worldview shaped by helplessness and hopelessness changes a developing mind far more than an occasional ketamine treatment under medical supervision.
So where does all this fear come from? Residual stigma and sensationalized headlines. Ketamine gets dismissed as a “horse tranquilizer” or a “club drug.” This language carries the weight of “the war on drugs” and decades of panic over misuse. It ignores ketamine’s long history as an anesthetic with a wide safety margin. Meanwhile, alcohol, a drug with no medical value and enormous social costs, remains normalized in adolescent life. If we are serious about weighing risks, the hypocrisy speaks for itself.
This does not mean ketamine should be handed out carelessly. I share concerns about the rise of “pump-and-dump” clinics, where patients are pushed through without support. This is not responsible care, nor is it what I am proposing. Responsible adoption means setting standards of practice, requiring training, and building oversight by multidisciplinary boards that represent medicine, therapy, and community. Adolescents should only be treated by clinicians trained in psychotherapy and adolescent development, not just in writing prescriptions.
So where do we go from here? First, more research. We need larger trials to map both risks and benefits with rigor. Second, education. Parents, clinicians, and the public need accurate information, not recycled scare language. And finally, policy. Regulators must distinguish between legitimate therapeutic use and opportunistic profiteering. We cannot allow stigma, sloppy clinics, or financial politics to dictate what therapies desperate families can access.
The USA Today piece called ketamine controversial, but I call it necessary. If the evidence shows better outcomes for treatment-resistant depression and suicidality than what we currently offer, why would we deny that option? Fear should not outweigh facts. And facts show ketamine is giving many adolescents something they have lost: relief, perspective, and the possibility of recovery.
With love and light,
John Moos, MD