Ketamine on Demand

Ketamine’s success in early trials has surprised and excited researchers who study mood disorders, a field where drugs like Prozac and Zoloft, paired with talk therapy, have been the main treatment options for decades. But, as with Mr. Gathman, interventions don’t work for up to 30 percent of those suffering from major depression.

Moreover, it can take up to two months to determine whether these interventions have any effect at all — a dangerously long time for those suffering from suicidal thoughts and other mood disorders, said Dr. Joshua Berman, the medical director for interventional psychiatry at Columbia University, who helps lead the development of the department’s ketamine program. Ketamine’s effects, on the other hand, are often immediate.

Though relatively new in the field of mental health, ketamine has been used in hospitals and on battlefields as an anesthetic since 1970. While the drug’s clearance by the Food and Drug Administration does not yet extend most ketamine treatments to mood disorders, any physician can prescribe it off-label to patients whom they believe might benefit — allowing the commercial ketamine business to flourish.

Chris Walden, the co-founder of Ketamine Media, a public relations firm that works with ketamine providers, said that ketamine clinics have grown from a few dozen to “many hundreds” in the United States but couldn’t give exact numbers.

Some of these providers are associated with academic institutions conducting clinical trials. Others operate out of private boutique-like clinics such as Nushama, which was recently opened on Park Avenue in New York City by designer Jay Godfrey.

And some patients skip the clinic entirely. Mindbloom, which launched in late 2018, is a telemedicine platform whose users get home delivery of ketamine lozenges. The company — among the fastest growing of several services enabling at-home ketamine therapy, like My Ketamine Home and TrippSitter — pairs its clients with psychiatric clinicians certified to prescribe drugs, who determine if the drug is appropriate for them. Then other employees, called “psychedelic guides,” meet with patients virtually before and after sessions to process the experience. There are no formal requirements to becoming a psychedelic guide, but most have completed training in fields such as mental health, life coaching or crisis management.

Dylan Beynon, Mindbloom’s chief executive and founder, said over 80 percent of his clients suffering from depression or anxiety experience significant improvement after four sessions — and that just 5 percent of patients experience side effects, which were mostly mild.