Dr John Torline

Important Update on Ketamine and Psychedelic Use in South Africa

The South African Society of Psychiatrists (SASOP) and the South African Society of Anaesthesiologists (SASA) have released a joint statement expressing concerns about the use of ketamine and psychedelic agents in clinical settings.

Key Points:
1. Ketamine for Psychiatry: It's considered a level 3 treatment for psychiatric use, meant only for specific, specialist-guided cases such as Treatment-Resistant Depression (TRD). Only a psychiatrist should prescribe this treatment.
2. Psychedelics: Currently illegal in South Africa, including psilocybin (“magic mushrooms or shrooms”) and M**A (“Ecstasy”). SASOP and SASA do not endorse their use for psychiatric conditions.
3. Clinical Guidelines: All treatments must align with Good Clinical Practice (GCP) guidelines. Off-label or illegal usage is strictly prohibited and can have severe legal and professional consequences.

Let's prioritise patient safety and adhere to ethical, evidence-based practices. For more details, visit the official SASOP and SASA websites.

Persistent Depressive Disorder

Persistent Depressive Disorder, also known as dysthymia, is a mood disorder characterised by chronic and persistent feelings of depression. It differs from major depressive disorder in that the symptoms are less severe but persists longer, typically lasting for at least two years in adults.

The symptoms of persistent depressive disorder include:

Depressed mood for most of the day, for more days than not, for at least two years (in adults) or one year (in children and adolescents). During this period, the person has never been without the symptoms for more than two months.

While depressed, two or more of the following additional symptoms are present:
1. Poor appetite or overeating.
2. Insomnia or excessive sleep.
3. Low energy or fatigue.
4. Low self-esteem.
5. Poor concentration or difficulty making decisions.
6. Feelings of hopelessness.

Importantly the person does not experience mania, and the depression cannot be attributed to a medical illness, medications or substances.

If left untreated, persistent depressive disorder can significantly impact an individual's daily functioning, relationships, and overall quality of life. It can lead to social withdrawal, decreased productivity at work or school, strained interpersonal relationships, and an increased risk of developing other mental health conditions, such as anxiety disorders or substance abuse.

There are several treatment options available for persistent depressive disorder, including:
1. Psychotherapy
2. Medication
3. Lifestyle changes
4. Support groups

It's essential for individuals experiencing persistent depressive disorder to seek professional help as early as possible. A mental health professional can provide an accurate diagnosis, develop an individualised treatment plan, and provide ongoing support to manage the condition effectively.

https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral

Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that focuses on changing a person's negative or harmful thought patterns and behaviours. It is based on the premise that our thoughts, feelings, and behaviours are interconnected and that thoughts can lead to behaviours and emotions. CBT aims to help individuals identify and challenge their negative beliefs and replace them with more positive and realistic ones. This is done through various techniques, such as cognitive restructuring, behavioural experiments, and exposure therapy.

What is Cognitive Behavioral Therapy? Numerous research studies suggest that cognitive behavioral therapy leads to significant improvement in functioning and quality of life.

So proud of our South African colleagues who were part of this panel!