Pop star Frankie Bridge, 37, has suffered with crippling depression and anxiety for decades – to the point that she was hospitalised in her 20s.
Now, the married mother of two is proclaiming the ‘life-changing’ benefits of therapy using ketamine, a drug notorious for being swiftly addictive and potentially deadly.
Ketamine is legally licensed in the UK, but currently only as an anaesthetic and painkiller.
When misused as a class B illegal drug, it can cause serious and permanent damage to the bladder, alongside other complications such as liver disease and memory loss.
Deaths from ketamine misuse increased ten-fold between 2014 and 2024, according to a report last year by the UK drug-death monitoring body the National Programme on Substance Use Mortality – with more than 690 deaths between 1999 and 2024 in England, Wales and Northern Ireland.
Frankie told Daily Mail columnist Bryony Gordon’s podcast The Life Of Bryony last month that while she was a member of the pop group The Saturdays between 2007 and 2014 she battled depression.
Despite trying multiple combinations of antidepressants over the years, Frankie, who is married to former England footballer Wayne Bridge, 45, says she still struggles. She told the podcast how a few years ago ‘I was starting to go into those patterns of “everyone would be better if I wasn’t here any more” ’.
Around that time, Frankie learnt about ketamine therapy for depression from a mental health professional, she said, but ‘I was terrified because I’ve never taken a drug in my life’.
Frankie Bridge learnt about ketamine therapy for depression from a mental health professional and describes it as ‘out of body experience’
During ketamine therapy, tiny amounts of the drug (far lower than in medical use as an anaesthetic or recreational misuse) are administered by professionals in a carefully controlled clinical environment.
In small psychiatric doses, it makes people dissociate, so the mind feels separated from the body and its surroundings.
Frankie described the therapy as an ‘out of body experience’. ‘Things you’ve maybe pushed down, things you’ve never processed before, it gives your brain a chance to process them,’ she said.
‘I can feel like I’m a piece of mud on a shoe and then it’ll go really bright and I feel free. It’s amazing. But at the minute it’s really expensive and not readily available, which is a shame.’
While ketamine is not licensed in the UK for routine treatment of depression, it can be prescribed ‘off-label’ by doctors and psychiatrists.
Indeed, a Good Health investigation has found that ketamine is increasingly being offered as a high-priced depression therapy in the UK by private clinics as well as in the NHS under self-pay schemes (patients pay for treatment at an NHS clinic and the money goes back into the health service) for depression and other psychiatric problems – and even, in one private clinic, for couples therapy.
Dr Rajalingam Yadhunanthanan, an NHS consultant in intensive care, has used ketamine privately on around 700 patients with psychiatric conditions and is evangelical about its efficacy.
He told Good Health: ‘It completely changes people’s lives. We have a 74 per cent success rate with people with treatment-resistant depression.’
Dr Yadhunanthanan, who works at a London NHS trust that does not wish to be named, provides ketamine therapy privately at his Save Minds clinic in London.
‘Getting referred for the treatment is a strict process,’ he says. ‘Patients need to be clinically assessed by a consultant psychiatrist who may then recommend the therapy. About 40 per cent of patients have been depressed for 30 years or more, and proven resistant to psychotherapy and drug treatments.
‘When you give ketamine you can watch quite rapidly over weeks how they get out of depression. They are able to communicate better with their therapist. Or they simply get the motivation to help themselves.
‘The psychiatric dose is 0.5mg per 1kg of the patient’s body weight. As an anaesthetic it is 1-2.5mg per 1kg of body weight.’
It’s also administered differently. ‘As an anaesthetic you give the dose quickly, but as a psychiatric dose it is given slowly (infused) over a 40-minute period,’ he says.
‘The patient is not asleep, they are talking to you. It’s a dissociative state. The drug takes away their immediate surroundings. We keep people under observation for two hours after the dose to ensure they are OK.’
At £600 per treatment, it is expensive, he admits. ‘We tell people their twice-weekly treatment is for a minimum of three to five weeks.
‘Then, based on their improvement, we may wean them down to once a week, once a fortnight, once a month and then stop. Typically, patients will receive 15-25 treatments over a period of six months.’
As well as depression, ketamine is used to treat anxiety, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD), he adds, ‘but usually with PTSD and OCD it takes longer’.
Joanna Moncrieff, a professor of critical and social psychiatry, says: ‘With ketamine, the evidence is crummy… These things have a huge placebo effect, but the benefit is not lasting’
And the approach seems to be gaining traction, as multiple NHS trusts and the Royal College of Psychiatrists are now pressing for it to be officially approved so it can be given more widely on the health service. At the forefront of the use of ketamine as a psychiatric medication is Oxford Health NHS Foundation Trust’s Interventional Psychiatry Service, where low-dose ketamine is offered for depression that has not responded to other medications or talking therapies to private-paying patients, as well as some NHS patients in the trust’s catchment area.
Patients need a referral from a GP or psychiatrist and undergo a detailed psychiatric assessment.
As for price, the trust says: ‘We do not recommend that you pursue ketamine treatment with us if you would not be able to afford £3,000 per year. Costs may exceed this.’
A spokesperson for Oxford Health NHS Foundation Trust told Good Health that in 2024 the service treated 142 patients, with an average of eight treatments each (a total of 1,156 doses).
Initial treatment consists of three to six ketamine infusions over three to six weeks, with at least two clinically qualified staff present each time.
The trust says about half of patients ‘respond well and want to continue treatment’, adding that ‘the majority relapse at some point but then respond again with further treatment’.
The spokesperson added: ‘Such treatment can be prolonged over years. Continued treatment is necessary for the benefit to be maintained.’ Indeed, the trust says that its longest-standing ketamine patient has received 230 doses over a 15-year period.
However, some experts are concerned about using ketamine in this way – not least because prolonged treatment carries the risk of serious bladder damage (even at lower doses).
Ketamine cystitis is a well-known condition in people who misuse the drug (affecting around a quarter) – and it is increasingly seen in young people turning up at A&E, NHS units warned last year. It’s caused by the body breaking down ketamine into toxic by-products that pass through the bladder, injuring its lining.
And the same damage can occur with the minute doses of ketamine in psychological therapy, according to a 2024 report by psychiatrists at South London and Maudsley NHS Foundation Trust. In the journal BMC Psychiatry, they described how a 28-year-old woman with severe treatment-resistant depression experienced improvement after ketamine therapy on the NHS.
However, she began complaining of painful ‘stinging during and after peeing’ which worsened progressively. Doctors diagnosed ketamine cystitis, and the ketamine treatment was stopped.
The patient was quoted anonymously in the journal as saying: ‘The ketamine was really helpful for my mood. I had more energy and motivation to do things. I was genuinely happy to be alive again.
‘Sadly, the urinary symptoms were horrible – like a really bad urinary tract infection… It made me start to dread each dose of ketamine, as the pain would be there for most of the day and night afterwards.
‘The decision to stop the ketamine was difficult, but so was the idea of continuing it.’
This is not the only negative serious side-effect. Oxford Health NHS Foundation Trust warns that ‘about 10 per cent of people who have a ketamine infusion have an experience that is very challenging’, but this ‘will almost always resolve within 15 minutes of stopping the infusion’.
More worrying, it adds: ‘Occasionally, people experience a worsening in their depressive symptoms and suicidality which persists for up to two weeks. Sometimes this is sufficiently unpleasant that they do not want to take further ketamine.
‘Those who do persist with further treatment often find that it starts to help after one or two more infusions.’
However, research by the trust, published in the journal BMJ Open in 2019, suggests ketamine may not be a lasting cure for the most serious symptoms.
The study of 14 patients who’d experienced suicidal ideas reported that, while 12 experienced reductions of those thoughts for up to three years with ongoing treatment, ‘re-emergence of suicidal thoughts often occurred when treatment ceased’. Despite such problems, the trust is pushing for full licensing approval for ketamine as a psychiatric drug.
Patients such as Frankie Bridge believe that ketamine has freed them from psychiatric illness
It told Good Health: ‘This would mean the treatment was available more widely on the NHS to those who would benefit from it as an alternative option to those considering ECT [electroconvulsive therapy – the controversial ‘brain-zapping’ treatment] on the grounds that ketamine is equally effective but does not have the cognitive side-effects of ECT [which can include memory loss].’
The Royal College of Psychiatrists ‘recommends the use of ketamine in specialist settings with appropriate oversight and long-term monitoring arrangements in place’. Its spokesperson told Good Health it is also calling on the NHS to license ketamine for psychiatric treatment.
Meanwhile, at private clinics in London and Manchester, Dr Wayne Kampers offers ketamine therapy for couples whose relationships are in crisis. As well as infusions of the drug, he has developed a more convenient method – suckable lozenges containing a small psychiatric dose of ketamine, which he has specially made. He calls it a ‘groundbreaking approach to relationship healing’ and mental health problems.
Dr Kampers argues that ketamine’s anti-anxiety and antidepressant effects can reduce emotional barriers, which helps couples to open up in his relationship therapy sessions. He also claims that it improves the brain’s neuroplasticity – its ability to form new neural connections.
‘In this way, ketamine creates a unique window of opportunity for couples to break free from rigid, unproductive thought patterns and communication habits.’
Yet neuroscientists remain unsure precisely how ketamine works as a psychiatric therapy.
Last year, researchers at King’s College London used a brain-scanning method called magnetic resonance spectroscopy to monitor activity in the brains of 26 patients with clinically diagnosed depression while they received low-dose ketamine.
In the journal Nature Medicine they reported that ketamine alters the action of the brain’s ‘feelgood’ opioid system, which may in turn boost mood and thus alleviate depression symptoms.
Dr Luke Jelen, a clinical lecturer in psychiatry, who led the study, said at the time: ‘Understanding whether the opioid system is involved in ketamine’s antidepressant effects is a really important question, given how much we still don’t know about how ketamine works.’
While ketamine is not licensed in the UK for psychiatric therapy, a chemical doppelganger called esketamine (brand name Spravato), developed by Janssen Pharmaceuticals, was controversially approved for this use in the UK by the Medicines and Healthcare products Regulatory Agency (MHRA) in 2019.
However, it has not been approved on the NHS because it’s not cost-effective, according to treatment watchdog the National Institute for Health and Care Excellence (NICE). This means that esketamine is offered only by a few private clinics in the UK.
But evidence of esketamine use, effectiveness and – most crucially – its safety in Britain is shrouded in secrecy. The MHRA’s monitoring systems for recording apparent bad reactions to esketamine report one serious case of a child aged nine or under, ten other serious bad-reaction reports – and one death, involving a female psychiatric patient, age unknown, in 2022.
Good Health asked Janssen for details on this death, but it said: ‘We cannot disclose whether any specific adverse event reports have been submitted [to the MHRA] or provide details of such reports.’
The MHRA acknowledged that the fatality report was submitted by Janssen, but added: ‘We cannot provide specific details of reports from individuals or for the patient involved in such reports.’
The MHRA is nevertheless sufficiently concerned about esketamine’s safety to have required Janssen to set up a special UK ‘register and alert system’ to record every patient given the drug. The MHRA told us: ‘The register and alert system is operated by Janssen and its data should be requested from them.’
Yet when Good Health asked Janssen, it said: ‘We do not have access to data connected to UK patients beyond what is publicly available, due to data privacy and pharmaceutical industry regulations.’
Good Health approached four private clinics in the UK whose websites offered esketamine therapy. Three refused to comment. One said that it did not currently offer the drug, but would not comment further.
Some experts argue that neither esketamine nor ketamine should be used in psychiatry at all. Joanna Moncrieff, a professor of critical and social psychiatry at University College London, says that NICE rejected esketamine ‘because the evidence for benefit was weak and did not justify its use.
‘With ketamine, too, the evidence is crummy. It only shows, unsurprisingly, that if you make people feel high for a few hours you can get rid of their depression. These things have a huge placebo effect, but the benefit is not lasting.’
As for couples therapy, Professor Moncrieff says: ‘We tried this already with ecstasy. It didn’t work.’
She warns: ‘I worry we may be heading towards the situation in the US, where there is a proliferation of ketamine clinics for desperate people who have not got better from conventional drug treatment.
‘The initial US idea was that ketamine-assisted psychotherapy would be faster than expensive and lengthy psychotherapy. But then the psychotherapy element gets knocked out. You end up with people in for regular ketamine on an ongoing basis. It is legalised drug-dealing, effectively.’
She argues: ‘We should not be raising people’s hopes with ketamine. We should be telling them that recovery from depression is complex. Recovery takes time and it requires individuals to identify what is wrong in their lives, the reasons why they are depressed; and to make changes with therapy and exercise. It is not, in my view, biological.’
While patients such as Frankie Bridge believe sincerely and passionately that ketamine has freed them from psychiatric illness, Professor Moncrieff warns starkly: ‘We are not doing people any favours by exposing them to yet another mind-altering substance.’