Depression is a societal menace. Millions of people worldwide deal with depression; some struggle to get by, while some get over it. A typical example is a 41-year-old sommelier in Chicago, Seth Wilson has dealt with depression and anxiety for many years. It started when Seth was 13 years old. Over time, he had to live with his panic attacks, which worsened when he lost his mother. He fed on antidepressant and anti-anxiety medications for more than ten years, but it wasn’t yielding the desired result. Luckily in the spring of 2020, Seth went to a Field Trip Health clinic close to Lake Michigan. He had his headphones and shades on and comfortably sat in a relaxing zero-gravity leather chair. Seth got a shot of the dissociative anaesthetic ketamine. He was on a total blast to the cosmos only a few seconds in.
He was struck by waves and waves of awe and a feeling that there was something beyond life. The familiar feeling of being overwhelmed with panic and fear was nowhere to be found. Seth said, “I realize, except for love and gratitude, nothing else matters.”
Since he started undergoing ketamine-assisted therapy, he has slashed his use of antidepressant and anti-anxiety medication up to 50%. The ketamine-assisted therapy has a sequence of six infusions preceding a session with a certified therapist. Seth had always wanted to do therapy with psychedelics like LSD or psilocybin (the active compound in shrooms). Many biotechnological companies are trying to develop medicines based on psilocybin, MDMA, and other Psychedelic molecules; many of these substances are illegal in the U.S. Many of these substances are yet to be approved by the FDA (Food and Drug Administration). Ketamine stands tall among the rest as it is legal, albeit under strict regulations.
Ketamine has reached the mainstream, and most of the credit can be given to its wide acceptance and the renaissance of psychedelics. A few companies across the country are forging ahead in this capacity. Mindbloom, Novamind, Neshama, and Field Trip Health are the leading firms that continue to expand their services to patients.
Most recently, the fantastic effects of psilocybin, LSD, and MDMA have it the headlines. Their potential to handle depression, anxiety, PTSD, and other mental ill-health was investigated and deemed reliable. Ketamine can leverage this growing interest in psychedelics.
Ketamine has a lot to offer. Compared to other psychedelics, the duration of its effect is short. One of the significant downsides of psychedelic-assisted therapy using drugs like MDMA, LSD, and psilocybin is the length of the experience. It takes around 4 to 10 hours for their effect to ease off.
The experience of Ketamine can last for a maximum of 2 hours. Interestingly, a few companies are trying to eliminate the psychedelic experience, while some are trying to modify it so the trip can get even shorter.
Currently, across Canada and the U.S., Field Trip Health has eight clinics. CEO Ronan Levy has said he sees visits from patients across every location rise significantly. By the end of 2021, the company said it would expand to 20 locations, and by 2024, it would scale to around 75 clinics nationwide. There is a growing demand for psychedelic-assisted therapy, and the FDA-approved MDMA or psilocybin still looks ahead.
Levy was quoted saying, “When people realize that there is a legal option which is readily available and provided with medical supervision and professional therapy, it becomes an enticing option.” Considering the legal options, they can be easily accessed, and it can account for the blossoming fame of Ketamine currently.
Ketamine has gone mainstream, and Field Trip is far from the only one reaping the benefits.
Novamind, which also owns a Utah-based chain of clinics under the name “Cedar Psychiatry”, which offers ketamine-assisted therapy, is also trying to keep up with the demand. Sometimes last year, the company said it had a two-week wait time at each clinic. Already with 20,000 patients and by estimate, it was expecting a 225% increase, resulting in about 65,000 patients.
Novamind CEO Yaron Conforti says due to the increase in mental health awareness during the COVID-19 pandemic, the use of Ketamine and psychedelics, in general, is enjoying quite a moment. Many people are looking for different types of treatment to ease off their mental health challenges. “It’s happening now; ketamine is having its time,” says Yaron Conforti.
Later, Ketamine was stigmatized as a party drug and a “horse tranquillizer.” Ketamine obtained FDA approval as an anaesthetic used in paediatrics. But FDA approval of Spravato in 2019 has led to the growing general interest in Ketamine. Spravato is a nasal spray containing Ketamine derivative esketamine. Manufactured by Johnson & Johnson’s Janssen, Spravato is approved to treat treatment-resistant cases of depression and their symptoms in adults with a significant depressive disorder who have suicidal thoughts or behaviour.
Craig Check, a psychiatrist who practices in Huntersville, North Carolina, says that “FDA approval of Spravato couple with the insurance company covering the drug, has indirectly ushered ketamine treatment to the mainstream.” He said when the Spravato was approved in 2019. Usually, he’d have just two to three patients a week. Currently, he’s seeing around twelve to fifteen patients daily.
“I don’t think this is ignorable,” Craig says. If it has not crossed the mind of every psychiatrist who handles cases of treatment-resistant depression, it has to dwell there now because it helps. Maybe not everyone reaps the benefits, but it helps many of these patients who have given up after exhausting every possible treatment.”
It’s an abstract notion, and that’s the best part of ketamine-assisted therapy, says Craig. “It ignites hope,” says Craig. And one of the best things a doctor can give a patient is hope, not a prescription. And for many, these psychedelic substances offer hope.” Positive patient outcome is another reason why ketamine-assisted therapy is gaining the game it is getting now. ,
“Daily, most of our clients come in depressed and step out feeling significantly better, if not completely relieved,” according to Ben Medrano, a psychiatrist/medical director at Field Trip.
Ketamine is just the first stage for companies like Field Trip. With time it will go beyond Ketamine to provide other psychedelic drugs if FDA eventually approves or if they are permitted under state programs. For instance, Oregon is in the closing stages of launching a psilocybin-assisted therapy program. Field Trip CEO Levy says the perfect way to envision Field Trip is to see it as a psychedelic therapy platform available to provide patients with a menu of psychedelic compounds to be used in therapy.
Levy said, “Our clinical infrastructure will be molecule agnostic.” “Different molecules will be served as every patient will have their molecule, and we are ready to support any psychedelic-assisted therapy. Whether psilocybin, MDMA, or our novel molecules, and if LSD gets approved, fantastic too.”
Some significant studies from New York University, John Hopkins, Imperial College London, the Multidisciplinary Association for Psychedelic Studies (MAPS), and similar institutions have shown promising signs that drugs like MDMA and psilocybin have tremendous therapeutic potential for conditions like depression, PTSD (Post Traumatic Stress Disorder), OCD (Obsessive-Compulsive Disorder), end-of-life anxiety and nicotine and alcohol dependence.
Field Trip has a big plan to flood the market with its hallucinogenic compound. It is developing a psychedelic molecule that targets the 5HT-2A receptor in the brain, the same receptor targeted by psilocybin; the plan is to get the approval of the FDA. The compound, temporarily named FT-104 by the company, comes with a trip that lasts for two hours or half the time associated with a magical Mushroom trip. Phase 1 of clinical trials will launch soon.
During Seth’s last ketamine session, he set out with the intention to see his late mother. Once the ketamine effect kicked in, his mother took him to experience her birth and showed him the afterlife. According to Seth, this experience helped him deal with the trauma of his mother’s demise. He also said it helped him manage his depression and anxiety by showing him something beyond the physical world.
He says, “We all are searching for the indescribable, and it’s so intensely personal.” “I think the word ‘God’ can be triggering for people, but the reality is about trusting and having faith that somewhere there’s something beyond ourselves. Then we realize this physical world doesn’t matter, and all the challenges facing us don’t matter either; there’s something beyond.”
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