A medical breakthrough, or a dangerous shortcut? Health Beat investigates the ketamine craze
What began as a good anaesthetic because of its pain-beating properties has evolved into a so-called game-changing treatment for depression, but with no clear guidelines, clinics are cashing in.
Also linked with the party scene and celebrity scandals, ketamine is promoted online as a treatment for migraines, anxiety, addiction and ADHD, but are these claims credible?
In South Africa, doctors can prescribe ketamine, even though drip infusions haven't been approved by our medicines regulator, Sahpra, for anything outside anaesthesia.
Specialists warn that ketamine therapy requires expert training and monitoring.
Psychiatrist Bavi Vythilingum, who runs a clinic offering ketamine infusions with an anaesthetist present, reports good results, but is concerned about 'cowboy clinics' run by doctors without extra training in psychiatry and anaesthesiology.
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The Citizen
7 days ago
- The Citizen
Women's Day: ADHD undiagnosed but still showing up
As South Africa marks Women's Day on August 9, the South African Society of Psychiatrists (SASOP) is calling attention to an often-overlooked struggle faced by women and girls living with undiagnosed or misunderstood Attention Deficit Hyperactivity Disorder (ADHD). This Women's Day, SASOP urges healthcare professionals, educators, and families to expand their understanding of the disorder. ADHD is often seen as a childhood disorder that affects disruptive, hyperactive boys. The outdated stereotype has left women and girls invisible in the conversation, their symptoms misunderstood or dismissed entirely. Dr Wisani Makhomisane, specialist psychiatrist and SASOP member, says that for too long, the disorder has worn a masculine mask: one that has obscured the quieter internal battles many women face every day. She explains, unlike boys who are more likely to display external hyperactivity, girls often internalise their symptoms. They are described as dreamy, anxious, sensitive or perfectionistic, qualities that are often misinterpreted as emotional immaturity or personality quirks. According to Makhomisane, the reality is the disorder in women is not less severe; it is simply less visible. 'These women are not lazy, disorganised or overemotional. They are living with a neurodevelopmental condition that continues to be poorly understood through a gendered lens. And the consequences are far-reaching.' Globally, boys are diagnosed with ADHD at nearly twice the rate of girls. According to data from the American Centre for Disease Control and Prevention,14.5% of boys receive a diagnosis, compared to just 8% of girls. This gap grows wider with age, with women often waiting four to five years longer than men to be correctly diagnosed. In South Africa, the situation is even more pronounced. Many women only receive a diagnosis in adulthood, often after years of struggling with anxiety, depression, low self-esteem, and a gnawing sense that something is wrong but not knowing what it is. Makhomisane explains that these women are frequently misdiagnosed. 'Their ADHD is often mistaken for anxiety disorders, depression or even borderline personality disorder. They are prescribed antidepressants or sedatives long before ADHD is ever considered. As a result, their care is often fragmented and ineffective, and their symptoms continue beneath the surface, contributing to emotional instability, eating disorders, and burnout,' she says. She points out that trying to meet the social expectations of being emotionally composed, high-functioning, and selfless, many women develop sophisticated masking behaviours to cope. They become overachievers, perfectionists or chronic people-pleasers not because they are naturally this way, but because they are desperately trying to manage the executive dysfunction and emotional overload that the disorder brings. 'But masking comes at a cost. It is mentally and physically exhausting, often leading to burnout, low self-worth, and a painful internal narrative of never being enough.' She emphasises this pressure is only amplified by motherhood. 'The demands of parenting expose executive dysfunction in a way that few other life stages do. Managing a household, juggling routines, and responding to emotional needs can become overwhelming. Many mothers with undiagnosed ADHD find themselves sinking under the weight of expectations, gripped by guilt, shame, and exhaustion, all while blaming themselves for not coping better.' ADHD in women often presents through chronic overwhelm, forgetfulness, disorganisation, emotional sensitivity, and deep rejection sensitivity. These are not personality flaws: they are symptoms of a neurodevelopmental disorder that deserves recognition, support, and care. 'Unfortunately, too many women blame themselves instead of understanding that their brains function differently and require different tools and strategies.' Makhomisane notes that this can lead to unhealthy coping mechanisms like emotional withdrawal due to fear of criticism, impulsive behaviours like binge shopping or risky decision-making, overcommitting to please others, and perfectionism to cover up underlying chaos. These behaviours are often misread, further delaying diagnosis and support. Treatment for ADHD involves a combination of approaches like medication, psychotherapy, and lifestyle interventions such as regular exercise, mindfulness, adequate sleep, and balanced nutrition. Therapy is especially important in helping women unlearn self-blame, develop emotional regulation, and build daily coping strategies that align with how their brains work. Makhomisane emphasises that if society can shift the lens through which ADHD is viewed, lives can be changed. For her it starts with awareness, early recognition, and the development of diagnostic tools and support systems that are sensitive to gender differences. It starts with believing women when they say, 'I'm struggling,' and listening with compassion and clinical insight. 'On this Women's Day, let us not only honour the strength of women but also create space for their struggles to be seen and supported. ADHD is not a flaw. It is not a failure. But the failure to recognise it, that is something we must urgently address.' ALSO READ: Mining concerns prompt rehab plan for Centurion school Do you have more information about the story? Please send us an email to [email protected] or phone us on 083 625 4114. For free breaking and community news, visit Rekord's websites: Rekord East For more news and interesting articles, like Rekord on Facebook, follow us on Twitter or Instagram or TikTok.
The Citizen
08-08-2025
- The Citizen
Weighing in: How South Africa's Ozempic attraction measures up globally
A doctor stated that although Ozempic has been available in South Africa for several years, its popularity has recently surged due to social media and celebrity influence. The lure of a shortcut, combined with the power of influence, could be fuelling South Africa's growing attraction to Ozempic. A recent report ranked South Africa fifth on a list of nations attracted to Ozempic based on metrics used to gauge interest in the medication. Despite researchers factoring in obesity rates, professionals have warned that Ozempic is not designed to treat obesity, but is a type 2 diabetes medication that requires a tailored diagnosis. Ease of Ozempic access Hailed as a weight-loss wonder drug, Ozempic is a semaglutide that increases insulin secretion, slows gastric emptying and reduces appetite. Researchers from Journo Report compiled data from 18 countries ranking internet search volumes, media mentions, obesity rates and regulatory restrictions. South Africa was the only African nation mentioned in the research report, which featured five countries from Asia and Oceania, four from the Americas, and eight from Europe. Ireland topped the charts based on interest, access and demand, with South Africa coming in fifth behind the United Arab Emirates (UAE), Mexico and Canada. 'South Africa also offers a relatively open regulatory environment, allowing broader access to Ozempic than many developed nations,' stated researchers. Of the nations analysed, France, Spain and Australia had the most stringent access regulations, while Mexico, South Africa and the UAE were at the opposite end of the regulatory scale. Ozempic is a schedule four medication, but South Africans were increasingly obtaining the product 'off-label'. Researchers stated that the UAE and Mexico had high rates of interest and easy access, while Canada's universal healthcare system allowed for easy distribution for diabetes, but limited access for weight loss. Local obesity rate South Africa's obesity rate of 32.8% was 7% higher than the average but lower than Ireland, the UAE and Mexico, and well below the US, which tipped the statistical scales at 45.6%. Obesity refers to an individual with a body mass index — a calculation using height and weight to estimate body fat — of 30 or higher. The report showed that Ozempic had a relatively small media presence in South Africa, averaging roughly 375 media mentions per month, compared to the 150 000 per month in the US. Based on internet behaviour, the Netherlands, Ireland and the United Kingdom (UK) had the highest per capita search volumes with 1 913, 1 844 and 1 733 searches per 100 000 people, respectively. The United States (US) and Australia registered 1 323 and 1 633 Ozempic-related internet searches per capita, but, like the UK, have stricter access, pushing them down the overall table. ALSO READ: Falsified Ozempic products flood the market, Sahpra urges caution Data from the World Obesity's Global Obesity Observatory shows South Africa has a growing overweight and obese population. In 1998, only 10% of men were considered obese, with 28% of women meeting that description. By 2022, those numbers had risen to 15% and 41%, respectively. Temporary results Medical practitioner Dr Marlin Mackay said Ozempic had been in the South African market for several years, but had only recently seen a rise in popularity due to social media prominence. He stated that initially there was a shortage of stock, but that supply has since caught up with demand. ALSO READ: How to treat diabetes McKay confirmed there were no generics on the market, only fake copies that were not approved by the South African Health Practitioners Regulatory Authority. 'Firstly, Ozempic is meant for type 2 diabetes and is not supposed to be a treatment for obesity,' said McKay, stressing that obesity is a chronic condition that requires long-term treatment. 'Patients need to be counselled and treatment needs to be individualised. 'Ozempic should not be used as a quick fix,' warned McKay. He warned that those with a family history of thyroid cancer should not use Ozempic and that a professional diagnosis should be obtained to 'understand the mechanisms' of their own bodies. McKay stressed that any weight-loss results would be temporary unless the underlying conditions are properly addressed. 'What patients don't realise is that as soon as they stop using it, there will be corresponding weight gain,' the doctor concluded. NOW READ: Billions' worth of weight loss and diabetes medications reached SA shelves and patients in 2024
TimesLIVE
07-08-2025
- TimesLIVE
Does SA need a Covid-like ministerial advisory committee to deal with HIV funding cuts?
Increase health taxes. Roll out the twice-a-year anti-HIV jab lenacapavir to stop HIV from spreading. Use artificial intelligence (AI) to do more with less. Convene a ministerial advisory committee. These are some of the things that have surfaced as potential solutions to fill the huge gap that US President Donald Trump's administration's sudden funding cuts in February have left. But would they work — and are they doable? Only if we move fast, and get lots of each thing, it seems. Health minister Aaron Motsoaledi told Bhekisisa's TV show, Health Beat, in July, that he 'would strongly consider' a ministerial advisory committee (MAC), like the one we had during the Covid pandemic for which scientists advised the health department on what to do. 'There's nothing wrong with establishing a MAC [to deal with funding cuts],' Motsoaledi admitted ... but we've not yet established anything like that for [the funding crisis].' No MAC or emergency think-tank with input beyond government structures has since been announced by the health department. But scientists warn such a committee should be an important part of the country's response to the crisis. 'We need to urgently convene a national think-tank,' medical doctor and the head of Wits RHI, Helen Rees, cautions. 'There are some really superb people who've been working in the programmes closely and well with the health department who could contribute their ideas and experience ... [and help figure out] what [strategies] can we [the health department] retain that aren't hugely expensive.' In Johannesburg, research released at the Conference on HIV Science in Kigali in July, shows HIV testing between January and March 2025 was 8.5% lower than the same time last year (before the funding cuts), and 31% less people were diagnosed with HIV in 2025. During the same period, there was also a 30% reduction in people who tested positive, who started on antiretroviral treatment, compared to 2024. So what has South Africa done so far? Motsoaledi has managed to raise a small amount of extra funding — R735m — from the treasury through the Public Finance Management Act. But it's less than 10% of the R7.9bn we've lost (and are in all likelihood about to lose in September, the end of the US financial year). The country is, however, starting to make progress with the rollout of lenacapavir, an injection that is taken once every six months, that provides near complete protection against HIV infection. About 170,000 people got newly infected with HIV in 2024, according to the latest Joint UN Programme on HIV and Aids report. A modelling study has shown if between two- and four-million people in the country take the jab, each year, for the next eight years, South Africa could end Aids as a public health threat by 2032. South Africa's medicines regulator, the South African Health Products Regulatory Authority, has told Bhekisisa the shot will be registered in the country before the end of the year. And, at a presentation at the Kigali conference, health department consultant Hasina Subedar said, if all goes well, the department will start to roll out the jab in April 2026. In July, the health department accepted an offer from the Global Fund for Aids, TB and Malaria, to reallocate R520m of its funds to buy lenacapavir from its maker, Gilead Sciences, over the next three years until cheaper generic versions become available. The funds will become available in October. But, if the health department budgets for the $60 per patient per year that the Global Fund has told them to, the grant is only enough to put about 400,000 people on preventive treatment for three years — about 10% of what is needed to end Aids by 2032. One more way to generate 'a stable and predictable funding stream' without donors, according to a July report by the public health organisation Vital Strategies, is to increase taxes on tobacco, alcohol and sugary drinks to a level where taxes constitute 50% of the selling price of the products. That money can then be used, among other things, to improve health infrastructure. According to the report, 45.7% of the price of a box of cigarettes, 27.6% of a bottle of beer and 3.4% of sugar-sweetened carbonated drinks currently go towards taxes in South Africa. Mia Malan recently asked Wits RHI's Helen Rees how the country should go about to find solutions to the HIV and TB funding crisis. Following is an edited version of the full TV interview.
