Cerebral but make it ketamine??

[wellbutrin.girlfriend]

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I just got an ad for this company on Instagram with tons of clients raving about their experience in the comments:

Mindbloom: ketamine therapy for anxiety and depression

Neuroplasticity that works, results you can trust. The only at-home ketamine therapy with proven outcomes for depression, anxiety, and PTSD. Get started today.

www.mindbloom.com

I had no idea that at-home ketamine therapy was even legal but I looked it up and was really surprised by how little regulation there is. This service is cash-pay only and your therapy sessions are "supervised" with a virtual check-in before and after with "psychedelic guides" who don't have any professional qualifications lol. Is this as shady as it sounds?

 

[Merovinge]

Interesting, they've certainly hired on a number of doctors and look primed to get into other psychdelic treatments with ketamine being the initial round of proof-of-concept to get more venture funding. Mental health startups with shady practices enabled by COVID loosening of what defines a medical visit are clearly an en vogue thing. I'm curious how much they will impact the landscape of mental health, as I am confident regulation will fail to keep up with the speed at which startups move.

 

[calvnandhobbs68]

lol $89/week for 3 months to start. Maybe I should get in on this.

I think this is also gonna get dicey for them going forward, but they might have enough physicians to argue it's legit (unlike Cerebral). But you're playing with a controlled med with no indication for that form or even robust studies (oral lozenges). A bad outcome=very hard to defend. I guess you could argue it's no different than all those IV ketamine clinics run by CRNAs and nobody's gotten in trouble for that so far, but at least those are in-person things.

 

[smalltownpsych]

Just ran into this with a local LPC who says that they are doing ketamine assisted therapy for trauma and wanted our NP to sign off on it. I just helped her craft an email saying no to this guy and also calling him out on the dynamic of getting patient caught in the middle and using patient to try and pressure the NP to go along with the plan.

That being said, I have actually partnered with a local physician and psychiatrist involved in using ketamine for treatments and this was under the auspices of a hospital and IRB. We saw some great results, but it is clearly an intensive and potentially risky intervention that should not be done without appropriate medical oversight.

 

[ObsequiousAplomb]

If things other than oral ketamine ever pan out legally (why would I give an oral anesthetic to someone??), I would be interested in offering this as a cash service, but certainly not in the way they're suggesting. Admittedly, this back of the envelope suggested setup had no real evidence to support it, but neither does oral lozenge ketamine via Zoom.

Start with a full psychiatric assessment to rule out psychological and medical contraindications (2 hours @ full fee). Screen out poly substance users, treatment naive, borderline, antisocial, and psychotic disorders. Come up with a comprehensive treatment plan including psychotherapy and pertinent medications.

Have several sessions of traditional therapy and preparation for the experience (4-6 hours @ full fee).

Have the sessions themselves in the office in an appropriate ambiance for a psychedelic experience. Appropriate monitoring and day-of prebrief and debrief (3 hours @ full fee each session x however many sessions).

Several sessions of traditional psychotherapy and future monitoring (4-6 hours @ full fee).

I guess all-told we're talking 15 minimum hours, up to however many sessions they want at an additional 3 hours/pop. Maybe lower the rates a little if it's a therapist doing that instead of me...but now that I think of it why would Iower the rates?

At $300 per hour we're talking $4500 minimum. At $500 per hour we're talking $7500 minimum? Their quoted $89/week is $1,246 for 14 weeks. They're majorly selling themselves short here.

 

[TexasPhysician]

Ryan Haight can’t return fast enough.

 

[Merovinge]

If things other than oral ketamine ever pan out legally (why would I give an oral anesthetic to someone??), I would be interested in offering this as a cash service, but certainly not in the way they're suggesting. Admittedly, this back of the envelope suggested setup had no real evidence to support it, but neither does oral lozenge ketamine via Zoom.

Start with a full psychiatric assessment to rule out psychological and medical contraindications (2 hours @ full fee). Screen out poly substance users, treatment naive, borderline, antisocial, and psychotic disorders. Come up with a comprehensive treatment plan including psychotherapy and pertinent medications.

Have several sessions of traditional therapy and preparation for the experience (4-6 hours @ full fee).

Have the sessions themselves in the office in an appropriate ambiance for a psychedelic experience. Appropriate monitoring and day-of prebrief and debrief (3 hours @ full fee each session x however many sessions).

Several sessions of traditional psychotherapy and future monitoring (4-6 hours @ full fee).

I guess all-told we're talking 15 minimum hours, up to however many sessions they want at an additional 3 hours/pop. Maybe lower the rates a little if it's a therapist doing that instead of me...but now that I think of it why would Iower the rates?

At $300 per hour we're talking $4500 minimum. At $500 per hour we're talking $7500 minimum? Their quoted $89/week is $1,246 for 14 weeks. They're majorly selling themselves short here.

This is clearly a venture based company looking for growth and broad market appeal. There are already boutique in-person services, they are creating a large margin tele-product that is easy to scale.