Ketamine Therapy for Depression: Clinical Protocol & Safety

WEBVTT

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So I'm Celeste and I'm here with Whitney and

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she's gonna introduce our friends today. We're

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gonna talk about mental health and ketamine and

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the way we interact with it in our setting and

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kind of my perspective of it of what I hear from

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patients and then we're gonna talk to people

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that do this every day. Some professionals that

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can give us like insight and help us understand

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how to consume it because I think From my perspective,

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people are throwing it around like it's curative.

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So that's the kind of thing. So why don't you

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get us started with, uh, yeah. Well, it is an

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honor to introduce Austin Frankham, nurse practitioner

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and, uh, Candice Cruzone, a licensed clinical

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social worker and owners of ketamine therapy

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at Therapeutic Alternatives. It's a top premier

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ketamine clinic in Utah. specifically West Jordan,

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but I know you guys make house calls as well.

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Welcome. Thank you. Oh, yeah. Here we go. So

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how a lot of people talk about ketamine in our

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space when there's dysmorphia or depression and

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they're coming in here for like hormone treatments,

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right? Coming here. They're doing hormone treatments.

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And I'm like, wow, this is the problem for an

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SSRI, you know? You need a little more support

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than progesterone or, you know, like some pre

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-pregnant alone, like a little neurotransmitter

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support. Yeah. It sounds like you're, like you

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have a good approach, I think, with progesterone.

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I think you're referring specifically to, like,

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premenstrual mood dysphoria. But, you know, there's

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sometimes more to our psyche than just... you

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know, just that. So, where, you know, there's

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no cure -alls, I guess, as we all know. And anything,

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dang it! Not even trizepatide! Son of a... Like

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a lot of things, you just use all the tools in

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your medicine bag and try to find something that

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you can, you know, collaborate and do the best

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for your patient, I guess. Yeah. Okay. Well,

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I'm excited. I'm going to let you answer, ask

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some questions. I think... People want to understand

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how ketamine therapy or ketamine treatment for

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mental health Issues work, you know, it's there's

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some there's some gap in knowledge of how it

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works, you know I guess you could say that it's

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even true technically of like SSRIs or whatever,

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right? But I think the kind of the front running

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theory is that it causes some It's a more of

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a neurogenesis theory, meaning it creates new

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pathways, the connections, and maybe reinforces

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some positive ones. You know, is that experiential?

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And, you know, like a lot of psychedelic drugs,

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you produce a novel experience, almost profound

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experience. um that can kind of rewire your your

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perspective or or your lens um sometimes i'll

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explain it to patients like it's uh you know

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in the 70s the magic viewfinder you're just changing

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the lens and oh the little circle guy yeah those

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are actually pretty cool that's a front -running

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theory we also like the the idea of uh you know

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there's more of a little bit more of a woo -woo

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type of theory where you know in our culture

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you know western culture i guess uh we don't

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have mystical experiences rites of passage and

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and medicines like ketamine other similar medicines

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may produce that kind of uh uh profound um mystical

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experience yeah like this is it really mystical

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i don't know well that's like kind of uh your

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own personal perspective right because whatever

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you encounter people extract meaning right something

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some people would call it luck or a blessing

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or you know things like that so it's kind of

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what you extrapolate or what your little boop

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boop What was that thing? The circle thing? The

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magic viewfinder. Like how many times do you

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click that a day and how many times do you recognize

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who's fingers on it? Things like that maybe?

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Or whatever else can be kind of stepping on your

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perception. It can be good for clarity sometimes,

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you know, just for a different lens on how you're

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viewing. Oh, I never thought of it that way.

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From a therapeutic sense, and that's kind of

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the way I approach it, is I like to describe

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ketamine as it provides a container, a safe container

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for you to go in and feel what you need to feel

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and pulls you back a little bit from the intense

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feelings of like trauma, depression, anxiety,

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and it kind of pulls you one step away so you

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can sit with it and look at it and feel what

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you need to feel in a really safe way. And so

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I kind of come to it from that side of kind of

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like It's just pulling back one step from your

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experience or your controls that you're putting

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on in a daily basis. What I've seen is really

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good for people with depression, anxiety, trauma,

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OCD, the thoughts that just take you down, the

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stories that take you down. It's you know, one

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thing I hear really early on are people just

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that they're like the thought that the stories

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they just don't take they just don't have as

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much control. They still come in. I still have

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them. I experienced it, but I'm like able to

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look at it and say, hey, this is a thought. This

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is a thought. So when you talk about that, some

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of the things that you're saying were people

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that are candidates. But where are they at on

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their journey that makes them a good candidate?

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Because I've met a lot of people in a few different

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professions that I've done. And sometimes I personally

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feel like they're not necessarily stable enough

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to go through ketamine, but I'm not quite sure

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of your criteria on how you. So really good point.

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You do want people, and we don't always know.

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We don't have to spend too much time with them.

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We always do a consultation, a pretty detailed

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consultation. Like a screening? A screening,

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initial screening. And then we, Austin and I

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will meet with them the first time they come

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in and do another screening to make sure, like

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they have a good support system, good resources.

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Not everybody does have the resources, the inner

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resources, to deal with whatever comes up because...

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Ketamine does shake things up a little bit. Um,

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so what does that mean? That's kind of a good

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coping mechanisms or to deal with, to deal with

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whatever volume. The problem is we can't always

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know that. And sometimes people, yeah, I feel

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like when we talk about ketamine or because I

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understand ketamine from a sedative standpoint,

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right? Which is you live in four milligram ish

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land or less, right? Actually, per kilogram,

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probably half a milligram to a milligram. Oh,

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so quite a bit less. And then the sedation is

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four milligrams and up, right? Yeah. Much higher

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than we ever use, yeah. Right. So for me, I understand

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it from a sleepy night to night. I'm like, farewell,

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it's dinnertime. Goodbye! So when you're like,

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we want people in the wedgie land, we want them

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still here with a foot in this world pliable.

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You don't want them. I mean, they won't come

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back with anything if we give them those. Sedation,

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right? Yeah, we don't. And, you know, we don't,

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yeah, we actually don't want to sedate them or

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anesthetize them out of their experience. We

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think that's important to, you know, along those

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lines of, you know, when it is appropriate, you

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know, there are, I mean, it can be nuanced. I

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mean, yeah, this is so interesting because every

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time I'm like, oh, I've got a grasp, you grab

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it and you're like, no, just kidding. some people

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like it feels because of it alters your level

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of consciousness right at the basis of it. Yeah,

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for sure. It definitely is. We kind of consider

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it a psychedelic intervention. So then when we

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talk about like just kind of generalized drug

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use, we can't always predict like it takes you

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eight glasses of wine and it takes me a thimble.

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Yeah. So it's kind of like that when we start

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to talk about it with patients, like it's not

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going to be something that's so specific and

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controlled. The weight based. you know, it's

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kind of what we have to go on to start with the

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patient. And obviously, you know, where you're

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where you're giving four milligrams per kilogram,

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I mean, we're talking about significantly higher

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dose that's still very safe. Yeah. You know,

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what Candice said is true as far as having support.

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But there you could make a counter argument saying

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You know, unlike SSRI, sometimes a drug like

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ketamine can work fairly quickly. Oh, I see.

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And there's some data that suggests it takes

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away suicidal ideation almost immediately, where,

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as you know, with prescribing SSRIs, it can take

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four to six weeks. And it can become worse in

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a certain amount of time. And I'm not against

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those drugs. I use those for patients. In tandem.

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Absolutely, because ketamine isn't all the time

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like how so let's go back to this You said at

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what point in my pathway would I be a good candidate?

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So you we're saying if they're more stable, but

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you also said suicidal ideation Because that's

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pretty immediate. That's somebody that needs

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help right now if if they have a plan, right?

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I mean if it were And that's where I guess our

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clinical decision making comes in. You know,

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being able to, is this an intervention we can

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make on an outpatient basis? What kind of set,

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having social support there, saying say someone

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does come in with suicidal ideation, we can do

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this treatment, we can safety plan with the family

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or friends or whoever their social support is,

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husband, wife. Um, but we, you know, we both

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worked in crisis a little and I think we have

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a good ability to assess. Yeah. We, um, basically

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people that we wouldn't work with is such a safe

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medicine that we would pretty much take anybody

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who comes in unless they are manic or psychotic.

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That's kind of our criteria. Okay. Yeah, that's

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an easier way. And is there any like respiratory,

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like if I had any conditions, would I not be

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a candidate, like disease processes? Yes, like

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what you mentioned, like with comorbidities where

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they're fairly fragile medically, I will usually

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refer them to the University of Utah. Very rarely

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do we see these kinds of patients, but occasionally

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you need to go where there's a higher level of

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care. There's an anesthesiologist available to

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support staff if there's a more intense medical

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event, but that's surprisingly rare. I mean,

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I think I can, maybe two people that I've ever...

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That's pretty good. When we started doing this,

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I think... Candice Lesoak, I think Candice had

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a better idea of how ketamine could work, but

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I really had it in my mind that you had to be,

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you know, you had to have nothing else to work

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for. I see, last resort. And that's how it was

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sold for years, how they did it for years, but

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not so much anymore. Like they would say, I would

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try, if you're treatment resistant, depression.

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and you tried multiple interventions and they

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failed, well, you can do ketamine, but we don't

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really, I think you could start with it, honestly.

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Yeah, I really had it in my mind. It was a coin

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flip between ketamine or ECT, but I kind of come

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back. As Kandace's vision was different, but

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as we worked with, I've come to, you know, the,

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you know, really high -functioning people, you

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know, can really benefit from it. You know, people

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that maybe are moderate, mild depression, whatever,

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anxiety seem to pull, going through life challenges,

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sometimes grief and loss. I mean, there's a broad

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scope of people that really find benefit from

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it that maybe wouldn't know. So we have almost

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everybody's a candidate and you guys have specialized

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screening tools that help protect people if they're

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not. Yes. And then depending upon where they're

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at in the process is primarily your judgment

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to see what skills they have when they leave.

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Yes. We'll find out pretty quickly if this isn't

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for them. Not everybody likes the feeling. It's

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a very strange feeling. It's weird. Um, not everybody,

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it isn't for everybody. Can I ask you, have you

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done Kandemi? I have. And have you yourself?

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It is why I wanted to do this and work with it

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is I'd had, um, I'd seen such good, um, outcomes

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with my patients. I worked at Elliott's hospital

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in the psych unit and, um, we had a lot of patients

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who were doing ACT and I had one doctor tell

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me that. they had better outcomes with patients

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that they would anesthetize. That's a hard one.

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They would add ketamine to it and then they would

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come out with better outcomes. And I was like,

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why don't we try ketamine first then? Because

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it's less invasive. And then if they need the

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ACT, we could do the ACT. And a couple of doctors

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did it. And it was crazy. I mean, I saw some

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really amazing things. In particular, there were

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two patients who had OCD that was so bad, they

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were hospitalized. And what I saw with these,

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and I'm thinking of two in particular, they were

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in the hospital, in and out, weeks at a time.

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And we tried ketamine on them first, and they

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had done ECT without a lot of success. And then

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they did ketamine, just ketamine, because it's

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less invasive. I just saw changes and I'm so

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quick. I got so excited about it. I left the

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hospital and open up my own practice, but I was

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so excited about what I'd seen in the hospital.

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I started sending my patients as a therapist

00:15:10.190 --> 00:15:12.309
to another ketamine clinic and it was crazy.

00:15:12.370 --> 00:15:14.370
They'd come back and their affect would be different.

00:15:15.379 --> 00:15:18.659
smile and laugh and therapy and we like it just

00:15:18.659 --> 00:15:22.059
something changed in them and So then I was interested

00:15:22.059 --> 00:15:24.659
in that like what I was sending them into So

00:15:24.659 --> 00:15:26.639
I contacted the ketamine clinic and asked if

00:15:26.639 --> 00:15:30.940
I could come and see what it was like for myself

00:15:30.940 --> 00:15:34.019
to kind of know what the experience was and It

00:15:34.019 --> 00:15:37.299
was my own work there that led me to decide that

00:15:37.299 --> 00:15:40.519
I wanted to do like this is my view Yeah, it

00:15:40.519 --> 00:15:42.919
was like I did it five times. I'm like, I'm I'm

00:15:42.919 --> 00:15:47.440
in and that's where we connected. I had worked

00:15:47.440 --> 00:15:49.759
at uni and he had also worked at uni and we decided

00:15:49.759 --> 00:15:52.320
we'd give it a try for our own patients because

00:15:52.320 --> 00:15:55.059
we'd had so many treatment failures. I think

00:15:55.059 --> 00:15:59.080
she told me, I don't want to put words in your

00:15:59.080 --> 00:16:01.100
mouth, but when she approached me about it she

00:16:01.100 --> 00:16:03.539
was like, you know, she felt like it was just

00:16:03.539 --> 00:16:08.340
the kind of... left her there. The experience,

00:16:08.899 --> 00:16:12.519
yeah. And I think her vision was to kind of have

00:16:12.519 --> 00:16:17.279
a therapist there. More supportive environment.

00:16:17.539 --> 00:16:19.580
A little bit more guided. I just kind of did

00:16:19.580 --> 00:16:22.379
my role as being the, you know, the providing

00:16:22.379 --> 00:16:25.039
that and her providing emotional support, which

00:16:25.039 --> 00:16:30.299
I think, you know. So if I come into your practice

00:16:30.299 --> 00:16:34.240
and I'm a candidate, then what's, what does it

00:16:34.240 --> 00:16:37.100
look like to get a treatment? Like what, like

00:16:37.100 --> 00:16:41.350
what is the experience? We usually, like, we'll

00:16:41.350 --> 00:16:44.049
review your medical history or psychiatric history,

00:16:44.149 --> 00:16:49.149
then we'll do a psych eval. I'll do a history

00:16:49.149 --> 00:16:53.850
in physical. It's very mental health, you know,

00:16:53.929 --> 00:16:58.289
not turned out. But, but, and then we'll just

00:16:58.289 --> 00:17:01.289
talk to you about. Nor this is kind of what Candice

00:17:01.289 --> 00:17:04.230
talks to you about really We prepare you for

00:17:04.230 --> 00:17:07.329
the session. We'll tell you what to expect You'll

00:17:07.329 --> 00:17:09.589
be in a room with either a couch or chair just

00:17:09.589 --> 00:17:12.289
really comfortable more therapy like a therapy

00:17:12.289 --> 00:17:15.789
rather than a softer room a couch So like am

00:17:15.789 --> 00:17:18.670
I getting an injection or an IV you could do

00:17:18.670 --> 00:17:21.230
either and then there's some people that do oral,

00:17:21.250 --> 00:17:23.730
right? We don't do that at the office. So you're

00:17:23.730 --> 00:17:27.990
an injection or an IV. Okay, we try to collaborate

00:17:27.990 --> 00:17:31.119
with That's part of the patient to see what's

00:17:31.119 --> 00:17:33.640
best. What route of administration feels good

00:17:33.640 --> 00:17:39.880
and dosing. And how long would I be? About less

00:17:39.880 --> 00:17:41.700
than two hours. I mean, you'll be in a kind of

00:17:41.700 --> 00:17:44.779
a dissociative state for less than an hour and

00:17:44.779 --> 00:17:46.980
probably a little intoxicated. So I should make

00:17:46.980 --> 00:17:49.099
a lot of decisions right after. Right then, right

00:17:49.099 --> 00:17:53.559
then. You have the space for two hours in our

00:17:53.559 --> 00:17:56.660
clinic. The deepest part of it is about 45 minutes

00:17:56.660 --> 00:17:58.619
to an hour. And then you have time to kind of

00:17:58.619 --> 00:18:01.980
come back and gather yourself before you have

00:18:01.980 --> 00:18:05.500
to. So what if I have a teenager in my life that

00:18:05.500 --> 00:18:08.880
has mental health issues? Like our teenager,

00:18:09.019 --> 00:18:12.640
I know teenagers do their own drugs, right? I've

00:18:12.640 --> 00:18:15.619
heard about it. I don't have a lot of experience

00:18:15.619 --> 00:18:18.079
with drugs, but all my experience has come through

00:18:18.079 --> 00:18:24.390
my children being like, what? the vape I really

00:18:24.390 --> 00:18:28.589
like I was raised in this state and I have little

00:18:28.589 --> 00:18:33.670
to no part of my like psych or my Patho and or

00:18:33.670 --> 00:18:38.170
not my path of my farm. I felt the drugs part

00:18:38.170 --> 00:18:46.529
I don't know which one but my kids they have

00:18:46.529 --> 00:18:51.460
tried some things and How does this affect a

00:18:51.460 --> 00:18:54.920
brain that has neuroplasticity because it's not

00:18:54.920 --> 00:18:58.000
yet formed? Question. What does that look like

00:18:58.000 --> 00:19:03.920
for these kids? Well, I think that when we've

00:19:03.920 --> 00:19:06.880
done it for teenagers, we won't go too young.

00:19:07.200 --> 00:19:09.220
And that's where we go to like the inner resourcing.

00:19:09.559 --> 00:19:12.420
Too young is how young? Below 15. I mean, there's

00:19:12.420 --> 00:19:14.759
a little bit of a question of like judgment.

00:19:16.029 --> 00:19:19.210
Everything. Everything. But there's something

00:19:19.210 --> 00:19:21.210
about working with teenagers that's so cool because

00:19:21.210 --> 00:19:23.789
their brains are so plastic and they don't have

00:19:23.789 --> 00:19:27.450
30 or 40 years of trauma. Oh my God. And ways

00:19:27.450 --> 00:19:29.250
of programmed in their head already. So it's

00:19:29.250 --> 00:19:34.589
like a horrible closet. It's like it's less to

00:19:34.589 --> 00:19:36.089
work through. Or the kitchen drawer. You have

00:19:36.089 --> 00:19:38.089
the kitchen drawer that you're like, what the

00:19:38.089 --> 00:19:45.819
hell? It's really fun to work with. What we do

00:19:45.819 --> 00:19:48.839
with, we take that on a case by case. We'll go

00:19:48.839 --> 00:19:53.220
down as 15, 16, not much younger than that. But

00:19:53.220 --> 00:19:56.240
we will always meet with them in person and make

00:19:56.240 --> 00:19:57.960
sure. Is the parent in these type of settings

00:19:57.960 --> 00:19:59.720
with you? They have to be. Because they're minors.

00:19:59.740 --> 00:20:02.720
So we won't, we always want to talk to the teenager.

00:20:02.720 --> 00:20:06.579
So you watch your kid go through a trip. I'm

00:20:06.579 --> 00:20:08.940
not supposed to call it that, right? Well, we,

00:20:09.180 --> 00:20:14.529
I mean, there's... It's a trip. It's not a big

00:20:14.529 --> 00:20:17.130
fall. You just watch them lay. They're laying

00:20:17.130 --> 00:20:19.069
there. They're just laying there and they're

00:20:19.069 --> 00:20:21.230
just traveling through space. But we always want

00:20:21.230 --> 00:20:23.289
to make sure that they want to do it and it's

00:20:23.289 --> 00:20:24.769
not the parent pushing them to do it because

00:20:24.769 --> 00:20:27.490
they're... They don't know what to do. We want

00:20:27.490 --> 00:20:29.369
to make sure they want to do it. And then we

00:20:29.369 --> 00:20:33.349
also are checking into making sure that they

00:20:33.349 --> 00:20:37.170
have the maturity to handle. This is a little

00:20:37.170 --> 00:20:38.630
bit more of where we check into, like, do they

00:20:38.630 --> 00:20:41.490
have the maturity to handle whatever? Like, it's

00:20:41.490 --> 00:20:44.069
because it's this crazy experience. We found

00:20:44.069 --> 00:20:46.910
just experiential. And this is true with, you

00:20:46.910 --> 00:20:49.230
know, particularly with kid with with minors.

00:20:49.980 --> 00:20:52.839
We want them to be on board with it. Yeah, that

00:20:52.839 --> 00:20:57.640
makes sense. People are more receptive to things

00:20:57.640 --> 00:21:00.319
that they're willing to participate in too, right?

00:21:00.500 --> 00:21:03.059
We feel like it will improve our chances of success

00:21:03.059 --> 00:21:05.740
with this. And so sometimes that can warrant

00:21:05.740 --> 00:21:07.579
a hard conversation with the parents saying,

00:21:07.900 --> 00:21:10.519
I don't... They're not ready. It's not your choice.

00:21:11.640 --> 00:21:14.279
We also like... any treatment team member involved

00:21:14.279 --> 00:21:17.440
with the kid on board. Yeah, for sure. They're

00:21:17.440 --> 00:21:21.339
having a therapist or their other mental health

00:21:21.339 --> 00:21:24.099
providers. So we like a little more of a team

00:21:24.099 --> 00:21:27.019
approach with with minors just to make sure everybody's

00:21:27.019 --> 00:21:29.099
on board with the program, including the patient,

00:21:29.240 --> 00:21:31.980
most importantly, the patient. So all you three

00:21:31.980 --> 00:21:34.599
have tried this. I've never had this. Tell me

00:21:34.599 --> 00:21:41.720
about it. I'm rough on Benadryl. I don't know.

00:21:42.640 --> 00:21:45.380
I'm like, uh, and my butt cheeks are so clenched

00:21:45.380 --> 00:21:48.160
to get all my gold. I don't know if I should

00:21:48.160 --> 00:21:50.960
be unclenching though. See what's in the closet.

00:21:52.039 --> 00:21:54.660
Like I've been shoving that shit in there so

00:21:54.660 --> 00:21:57.700
long. It's all buttoned up. I don't know. I think

00:21:57.700 --> 00:22:01.400
ketamine is probably the best medicine for butt

00:22:01.400 --> 00:22:07.039
clenchers. I've been using ketamine, um, Ketamine

00:22:07.039 --> 00:22:09.880
therapy regularly, there is a big difference

00:22:09.880 --> 00:22:12.299
between recreational ketamine and ketamine you

00:22:12.299 --> 00:22:15.079
can get in a clinic. Oh, yeah. And I think it's

00:22:15.079 --> 00:22:18.359
like a lot of the concern about, oh, ketamine

00:22:18.359 --> 00:22:21.660
therapy is about recreational use, the Matthew

00:22:21.660 --> 00:22:24.819
Perry and stuff. And like, and I'm seeing it

00:22:24.819 --> 00:22:27.160
everywhere. When I lived in L .A., like all my

00:22:27.160 --> 00:22:29.339
neighbors were like, hey, you want some cake

00:22:29.339 --> 00:22:32.900
or like I see it everywhere. Well, I didn't even

00:22:32.900 --> 00:22:35.759
know that that's what Perry's I didn't know that.

00:22:35.839 --> 00:22:40.839
Oh yeah. So I think there is such a difference

00:22:40.839 --> 00:22:45.160
because in the clinic it is like to me it's like

00:22:45.160 --> 00:22:48.220
okay I'm gonna go do my homework on my mental

00:22:48.220 --> 00:22:51.299
health. I don't bring my phones on silent. I

00:22:51.299 --> 00:22:53.500
don't have anywhere to be except this place where

00:22:53.500 --> 00:22:57.180
I'm monitored and it's for me. Oh. And you know

00:22:57.180 --> 00:23:00.900
like unless I'm a millionaire or billionaire

00:23:00.900 --> 00:23:03.680
like Elon Musk I'm not gonna be able to afford

00:23:03.680 --> 00:23:06.859
ketamine treatments. three times a day or whatever.

00:23:07.059 --> 00:23:10.160
So I think there is a huge difference between

00:23:10.160 --> 00:23:14.740
the stigma on using a recreational drug versus

00:23:14.740 --> 00:23:18.319
using a medication that is in a controlled setting

00:23:18.319 --> 00:23:22.319
with support and kind of outcomes. Yeah, I agree.

00:23:22.460 --> 00:23:24.799
I mean, supervision is important with that too,

00:23:24.839 --> 00:23:28.799
right? If, yeah, quite frankly, if Matthew Perry

00:23:28.799 --> 00:23:33.059
had, he'd been in a clinic. He'd be alive. That

00:23:33.059 --> 00:23:37.059
makes my feelings hurt. He was doing a mix. He

00:23:37.059 --> 00:23:43.859
was in clinic receiving therapy. He was using

00:23:43.859 --> 00:23:46.119
it therapeutically, but he was using it additionally

00:23:46.119 --> 00:23:49.019
at home. Can I ask you a weird question? What

00:23:49.019 --> 00:23:51.619
about the patients that have addiction that would

00:23:51.619 --> 00:23:56.480
be concerned to come? And then I have one other

00:23:56.480 --> 00:23:59.259
question that's even another layer. Because I

00:23:59.259 --> 00:24:02.880
see a ton of people do ayahuasca stuff. How,

00:24:02.900 --> 00:24:06.619
what land does this live in and microdosing and...

00:24:06.619 --> 00:24:10.640
You can ask these ladies about ayahuasca. Well,

00:24:10.880 --> 00:24:14.140
let me, I'll stop laying my questions and really

00:24:14.140 --> 00:24:18.700
go with the first one. Well, so addiction with,

00:24:18.700 --> 00:24:22.220
with, I mean, it's a bit, I mean, it's, it's

00:24:22.220 --> 00:24:24.740
nuanced because it is an abusable substance,

00:24:25.200 --> 00:24:28.289
right? Right. With ketamine, this is probably

00:24:28.289 --> 00:24:30.670
true of most psychedelics. There's not a direct,

00:24:31.410 --> 00:24:34.869
let's take an opiate for example. You take an

00:24:34.869 --> 00:24:36.950
opiate, you have a predictable response. Let's

00:24:36.950 --> 00:24:39.430
tell people what a normal opiate is. Like heroin

00:24:39.430 --> 00:24:42.490
or... There you go. And what's a prescribed opiate?

00:24:42.710 --> 00:24:47.990
Oxy. So you get a predictable response. You also

00:24:47.990 --> 00:24:51.430
get physical addiction. You neuro -adapt and

00:24:51.430 --> 00:24:55.019
you become dependent on that type of... Um, with

00:24:55.019 --> 00:24:58.279
psychedelics and ketamine as included, the response

00:24:58.279 --> 00:25:01.440
isn't predictable, nor is it pleasurable. Um,

00:25:01.440 --> 00:25:04.079
people may have some reliance on it because it

00:25:04.079 --> 00:25:07.160
alleviates some of their symptomatic relief.

00:25:07.799 --> 00:25:10.859
And yes, you can abuse almost any drug or a lot

00:25:10.859 --> 00:25:13.599
of other things for that matter. Um, so there

00:25:13.599 --> 00:25:16.579
is a, there is some danger there with, with abuse,

00:25:17.000 --> 00:25:20.460
but, um, generally when people are doing it in

00:25:20.460 --> 00:25:25.609
the supervised setting, you know, the. and they're

00:25:25.609 --> 00:25:29.049
in therapy, they're connected with their provider,

00:25:29.210 --> 00:25:33.690
their therapist. We have patients in recovery

00:25:33.690 --> 00:25:38.529
that go to their 12 -step meetings, and so if

00:25:38.529 --> 00:25:41.210
they have that support, their use of ketamine

00:25:41.210 --> 00:25:44.710
can actually reduce relapse rate significantly

00:25:44.710 --> 00:25:50.140
for... Alcohol, stimulants, about cut that in

00:25:50.140 --> 00:25:55.019
half. Statistically, opiates, it's very marginal.

00:25:55.299 --> 00:25:58.140
So what if I'm like, ooh, should I do ketamine

00:25:58.140 --> 00:26:02.180
or should I go do ayahuasca in Mexico? Like if

00:26:02.180 --> 00:26:06.019
that's like, because I see that all the time

00:26:06.019 --> 00:26:08.339
in my practice. People are like, you know what's

00:26:08.339 --> 00:26:11.200
cheaper? Going to Mexico. And I'm like, You know

00:26:11.200 --> 00:26:15.079
what's safer? Not coming to me. They're just

00:26:15.079 --> 00:26:19.000
different. They're just very different. They're

00:26:19.000 --> 00:26:20.819
both beautiful. They're not comparable. They're

00:26:20.819 --> 00:26:24.079
not mutually exclusive. I think what people are

00:26:24.079 --> 00:26:26.880
doing in Mexico is a drug called Ibogaine. Oh,

00:26:26.880 --> 00:26:29.980
you're right. Well, and ayahuasca. Which Ibogaine,

00:26:30.079 --> 00:26:33.079
I would say, is potentially cardio toxic. And

00:26:33.079 --> 00:26:36.819
they talk about it helping with addiction and

00:26:36.819 --> 00:26:41.579
PTSD. There was that. They had one on Netflix,

00:26:41.579 --> 00:26:47.279
right, that was about it for alcoholism and PTSD.

00:26:47.279 --> 00:26:49.740
It's great for addiction. Outside the U .S. it's

00:26:49.740 --> 00:26:51.519
supposed to be pretty phenomenal. I guess the

00:26:51.519 --> 00:26:54.039
former governor of Texas is really promoting...

00:26:54.039 --> 00:27:00.599
Oh, really? Well, last week, our president did

00:27:00.599 --> 00:27:04.720
a good thing. And he took it off. He signed a

00:27:04.720 --> 00:27:08.000
bill to let them do more studies on it legally.

00:27:08.680 --> 00:27:10.059
So there's some good things coming down the line.

00:27:10.339 --> 00:27:12.599
But they're not... The thing that's nice about

00:27:12.599 --> 00:27:14.940
ketamine is it's available now. It's available

00:27:14.940 --> 00:27:16.599
here. You don't have to go out of the country.

00:27:17.339 --> 00:27:21.240
It's legal. Oh, that's a good one. It doesn't

00:27:21.240 --> 00:27:23.119
interact with other medications. It doesn't interact

00:27:23.119 --> 00:27:25.140
with other medications. Because of the half -life,

00:27:25.319 --> 00:27:29.190
it's a short medication, right? No serotonin

00:27:29.190 --> 00:27:34.410
syndrome. Ayahuasca is... SSRIs. You can't do...

00:27:34.410 --> 00:27:39.589
Reddit over here. Lift it! Lift it! Not Reddit.

00:27:40.029 --> 00:27:42.269
I've done ayahuasca quite a few times. I think

00:27:42.269 --> 00:27:45.390
it's like such a beautiful medicine, but it is

00:27:45.390 --> 00:27:48.170
like... Every time I'm about to go to those ceremonies,

00:27:48.269 --> 00:27:52.069
I am anxious. I'm like, Oh God, again, it's never

00:27:52.069 --> 00:27:56.130
like, it's a deep, really deep experience, very

00:27:56.130 --> 00:28:00.589
like physical too. And with ketamine, like it's

00:28:00.589 --> 00:28:04.609
quick. I can go back to work the next day. And

00:28:04.609 --> 00:28:10.150
like, you can take a ketamine with SSRIs where

00:28:10.150 --> 00:28:14.410
ayahuasca you either it doesn't work. Because

00:28:14.410 --> 00:28:17.049
it's finding the same receptors. Serotonin syndrome

00:28:17.049 --> 00:28:20.470
could happen. Oh, little zaps, little brain zaps.

00:28:20.470 --> 00:28:24.069
I lost itself as an MAOI, and so you get all

00:28:24.069 --> 00:28:28.670
the risks there. I think all these drugs or medicines

00:28:28.670 --> 00:28:33.190
have some value, but I think ketamine has a little

00:28:33.190 --> 00:28:35.210
bit of a foot in the Western world where, you

00:28:35.210 --> 00:28:43.539
know, licensed. Most people aren't going to find

00:28:43.539 --> 00:28:47.519
their way into a psilocybin ceremony or an ayahuasca

00:28:47.519 --> 00:28:51.829
ceremony, just in general. It's hard. It's kind

00:28:51.829 --> 00:28:53.990
of a bridge too far to hang out with Whitney.

00:28:56.990 --> 00:29:00.390
It's fun. It's fun. But it is a bridge too far

00:29:00.390 --> 00:29:02.829
for a lot of people who have never, who have

00:29:02.829 --> 00:29:04.569
never stepped their foot into this world at all.

00:29:04.710 --> 00:29:06.789
So this is a very, this is like, Oh, we've got

00:29:06.789 --> 00:29:08.450
a therapist here and we have a nurse practitioner,

00:29:08.470 --> 00:29:10.809
a doctor and it feels a little bit, a little

00:29:10.809 --> 00:29:14.349
bit safer. It's more available. Yeah. What about,

00:29:14.450 --> 00:29:17.509
what about the costs? It's the secret, right?

00:29:17.769 --> 00:29:20.470
That's the thing. How much does my insurance

00:29:20.470 --> 00:29:24.150
cover this? We are cash only, but there are places

00:29:24.150 --> 00:29:26.230
that have been able to find a sneaky way around

00:29:26.230 --> 00:29:29.940
it. Um, when we talk about off label, what we're

00:29:29.940 --> 00:29:33.279
saying is it's not been studied because a lot

00:29:33.279 --> 00:29:36.380
of people don't understand what off label because

00:29:36.380 --> 00:29:39.559
we use stuff all the time. Let's talk about Viagra.

00:29:39.720 --> 00:29:42.619
Once upon a time, it was just a little blue pill

00:29:42.619 --> 00:29:46.079
trying to save someone's blood pressure. Now

00:29:46.079 --> 00:29:49.799
it's the wiener wonder. Yeah. And it was used

00:29:49.799 --> 00:29:53.670
off label for how long? Like how long? So when

00:29:53.670 --> 00:29:55.869
we want to talk about off -label, we have to

00:29:55.869 --> 00:29:58.890
remember that it doesn't make a medication bad.

00:29:59.549 --> 00:30:02.309
Right. It's just not ready yet. Off -label for

00:30:02.309 --> 00:30:05.390
depression. Yeah. It hasn't been studied for

00:30:05.390 --> 00:30:08.029
this particular thing, but we've studied the

00:30:08.029 --> 00:30:11.269
hell out of it for sedation at higher doses.

00:30:11.269 --> 00:30:14.589
And it has actually been approved for depression

00:30:14.589 --> 00:30:19.930
in the way that they give it. So Spravato is

00:30:19.930 --> 00:30:24.490
approved for depression. And it's the way that

00:30:24.490 --> 00:30:27.089
you receive the medicine, right? It's kind of

00:30:27.089 --> 00:30:30.589
like the dose shot. It's the manner of how they

00:30:30.589 --> 00:30:33.269
dose you. We have studied it in this proprietary

00:30:33.269 --> 00:30:36.950
delivery method that makes you pay us more, like

00:30:36.950 --> 00:30:42.890
that. And it's cute, it's purple. I mean, I think

00:30:42.890 --> 00:30:46.029
Sprovato is a derivative of the racemic ketamine

00:30:46.029 --> 00:30:48.609
that we use, so they're able to brand it as a

00:30:48.609 --> 00:30:52.990
new drug, therefore they can... No! can charge

00:30:52.990 --> 00:30:56.430
a lot. The medicine itself is actually pretty

00:30:56.430 --> 00:30:59.049
inexpensive. What you're paying for in the clinic

00:30:59.049 --> 00:31:02.650
is the time, the space, the overhead, the education.

00:31:03.569 --> 00:31:06.910
It's not really the medicine. The way they're

00:31:06.910 --> 00:31:10.950
making money. I tell people every day, I'm like,

00:31:11.130 --> 00:31:13.769
Botox doesn't matter. You rub it on your own

00:31:13.769 --> 00:31:18.150
face. I don't care. It's my hands. Right. It's

00:31:18.150 --> 00:31:23.650
the education. And Georgetown. All of those student

00:31:23.650 --> 00:31:27.809
loans. Because that's a way that they have found

00:31:27.809 --> 00:31:30.309
a way to make money off of ketamine because nobody

00:31:30.309 --> 00:31:33.710
is going to make money off of ketamine just based

00:31:33.710 --> 00:31:35.470
on the medicine because it's not that. expensive.

00:31:35.569 --> 00:31:37.730
It is what it's where you go and what they're

00:31:37.730 --> 00:31:39.750
doing with it and how they how they do it so.

00:31:39.930 --> 00:31:42.089
I would guess the clinics that take insurance

00:31:42.089 --> 00:31:46.750
they they'll bill for like a office visit like

00:31:46.750 --> 00:31:49.289
a 99214 and then procedural like starting an

00:31:49.289 --> 00:31:53.609
IV and then they make up that difference with

00:31:53.609 --> 00:31:57.609
the the labor costs either by cutting the amount

00:31:57.609 --> 00:31:59.890
of people that are oversight you know overseeing

00:31:59.890 --> 00:32:04.779
it or billing additional costs. So in your land,

00:32:04.960 --> 00:32:08.619
what does it cost if I'm coming to them? They're

00:32:08.619 --> 00:32:12.160
all like, here's all the secrets. OK, so it's

00:32:12.160 --> 00:32:16.460
300 for intramuscular. OK. And it is 400 for

00:32:16.460 --> 00:32:18.920
IV. It's a little more. It doesn't sound bad.

00:32:19.059 --> 00:32:20.819
It's a little more for the IV just for the placement

00:32:20.819 --> 00:32:25.480
of it. So your IV pricing is 400 and your IM

00:32:25.480 --> 00:32:28.900
pricing is 300. And then we do offer a package

00:32:28.900 --> 00:32:32.309
where if you buy a series of six Which is the

00:32:32.309 --> 00:32:35.069
protocol it has been studied. We give you the

00:32:35.069 --> 00:32:38.069
price of we give you six visits for the price

00:32:38.069 --> 00:32:41.470
of five and that brings the price down to 249

00:32:41.470 --> 00:32:46.130
or 349 I believe so one more time So when you

00:32:46.130 --> 00:32:48.589
now you're jumping back to studies when we talk

00:32:48.589 --> 00:32:50.849
about it this way We're talking about studied

00:32:50.849 --> 00:32:54.069
for what you're doing, but not studied for the

00:32:54.069 --> 00:32:57.569
FDA's guidelines Because the FDA isn't setting

00:32:57.569 --> 00:33:00.630
the standard of care. They're protecting the

00:33:00.630 --> 00:33:03.549
consumer So we always have to remember this.

00:33:04.130 --> 00:33:07.569
The FDA is not setting the standard of care we

00:33:07.569 --> 00:33:10.289
want. They're putting the bar on the place we

00:33:10.289 --> 00:33:14.289
can trip. Right? Right. Yes. That's exactly.

00:33:14.529 --> 00:33:17.450
So we just want to remember that we don't, there's

00:33:17.450 --> 00:33:19.670
a lot of times where we discount and say that

00:33:19.670 --> 00:33:21.950
it's not a good organization. I don't live in

00:33:21.950 --> 00:33:26.309
that land. I just remember what it's for, not

00:33:26.309 --> 00:33:30.559
for what I need. Right. It's like, here's a seatbelt

00:33:30.559 --> 00:33:33.380
and, and yeah, we're actually getting out of

00:33:33.380 --> 00:33:34.839
the car and you're like, I need to take off the

00:33:34.839 --> 00:33:38.140
seatbelt. Yes. You know, it is time I'm walking.

00:33:38.799 --> 00:33:43.440
So that doesn't actually, to me, I live in med

00:33:43.440 --> 00:33:47.799
spa land. So that's like one round of Botox for

00:33:47.799 --> 00:33:51.160
a couple treatments. Yeah. I mean, if you do

00:33:51.160 --> 00:33:56.079
a series of sticks. It's 14 .95 in our clinic.

00:33:56.519 --> 00:33:58.859
And it varies from clinic. That's about what

00:33:58.859 --> 00:34:01.119
it is. But it ends up being about 249 per session.

00:34:01.339 --> 00:34:04.460
That's a little less than Jigs in some people's

00:34:04.460 --> 00:34:07.539
clinics. So I'm just comparing it to my math.

00:34:07.880 --> 00:34:11.940
Or if you think about your life and your stability

00:34:11.940 --> 00:34:18.000
and that feeling of the lack of anxiety, I think

00:34:18.000 --> 00:34:22.650
that sounds pretty reasonably good. That was

00:34:22.650 --> 00:34:25.409
pre -blood clenching, and that's a good price,

00:34:25.550 --> 00:34:31.670
actually. I was like, aw. Six treatments is kind

00:34:31.670 --> 00:34:35.230
of arbitrary. That's your studies, but you can

00:34:35.230 --> 00:34:38.409
evaluate. I think most providers do. We've had

00:34:38.409 --> 00:34:41.250
patients do less and get benefit. The reason

00:34:41.250 --> 00:34:43.849
we want to stop at six is to take a drug holiday,

00:34:44.469 --> 00:34:48.230
see how long your symptoms are. or in your mission.

00:34:48.730 --> 00:34:51.650
For the node. And then the other thing is you're

00:34:51.650 --> 00:34:54.670
saying we need time to clinically evaluate your

00:34:54.670 --> 00:34:59.289
benefits. So yeah, if I can just maybe see if

00:34:59.289 --> 00:35:01.570
I understand. Yeah, you don't really build much

00:35:01.570 --> 00:35:03.329
of it. You don't build a tolerance to the stroke.

00:35:03.670 --> 00:35:06.570
It's not about tolerance. It's about regulation

00:35:06.570 --> 00:35:10.090
of the binding receptors. And if they're allosteric,

00:35:10.289 --> 00:35:13.750
the type of binding it is. This must be nerds.

00:35:24.410 --> 00:35:27.969
So if you're talking about like insulin, right?

00:35:28.090 --> 00:35:30.570
So you develop insulin resistance and that's

00:35:30.570 --> 00:35:34.090
not because you've taken medications. That's

00:35:34.090 --> 00:35:37.789
a response to high blood glucose constantly.

00:35:38.230 --> 00:35:41.429
Right. And how often or close together can you

00:35:41.429 --> 00:35:44.429
do these treatments? The study we go off of does

00:35:44.429 --> 00:35:48.429
it twice a week. for practicality reasons. It's

00:35:48.429 --> 00:35:51.110
a, we do it about once a week because most people

00:35:51.110 --> 00:35:54.989
don't have time to take two hours off. They had

00:35:54.989 --> 00:35:57.269
to have a right there. So we're, we're kind of

00:35:57.269 --> 00:36:00.130
deviating a little bit from that and, and we

00:36:00.130 --> 00:36:02.050
try to accommodate what the patient wants to

00:36:02.050 --> 00:36:06.969
do. Um, you know, usually I would say, you know,

00:36:07.550 --> 00:36:10.860
I, what would you say? I'd say. More than 50

00:36:10.860 --> 00:36:14.519
% of people will notice a return of symptoms.

00:36:14.880 --> 00:36:17.079
It just depends on how long that is. It might

00:36:17.079 --> 00:36:19.840
be six months, might be a year, maybe three months.

00:36:20.400 --> 00:36:25.639
There's no... Way to measure. Right. And there's

00:36:25.639 --> 00:36:29.000
so much variability of what we're exposed to,

00:36:29.360 --> 00:36:33.619
cortisol, our coping mechanisms, situational...

00:36:33.619 --> 00:36:35.900
Kind of what you're saying with receptor regulation,

00:36:36.260 --> 00:36:39.349
it varies from person to person, right? It does,

00:36:39.349 --> 00:36:42.750
but you can start to notice it's variable, but

00:36:42.750 --> 00:36:45.929
there's that bell curve where you see it occur.

00:36:46.170 --> 00:36:49.110
And if you're seeing a study where you're indicating

00:36:49.110 --> 00:36:52.650
there's six, there's usually enough of the data

00:36:52.650 --> 00:36:58.949
to say, aha! He's like, no, psychedelics! Mushroom

00:36:58.949 --> 00:37:03.090
rules! I think the problem with that is just

00:37:03.090 --> 00:37:06.090
that there isn't great longitudinal studies.

00:37:08.400 --> 00:37:11.340
We've noticed just anecdotally the variability

00:37:11.340 --> 00:37:14.659
of positive benefits seems to be pretty broad

00:37:14.659 --> 00:37:18.780
between individual patients. So where is ketamine

00:37:18.780 --> 00:37:21.619
synthetic? It is synthetic, yeah. Does it mimic

00:37:21.619 --> 00:37:25.539
any molecule in nature? No. I want to say it's

00:37:25.539 --> 00:37:29.780
from the aliens. It's from the aliens. Yeah,

00:37:30.380 --> 00:37:32.760
there's something to it. But it could be because

00:37:32.760 --> 00:37:36.420
I work in tech. It was developed in the 60s.

00:37:36.570 --> 00:37:40.909
during Vietnam because it's so safe. It doesn't

00:37:40.909 --> 00:37:42.590
do anything to your heart or your breathing.

00:37:42.909 --> 00:37:45.849
That seems like an oxymoron. That it was developed

00:37:45.849 --> 00:37:49.590
during Vietnam because it was safe. They could

00:37:49.590 --> 00:37:51.670
give it to each other. They were like, for you.

00:37:52.150 --> 00:37:54.489
They could give it to each other. Would you like

00:37:54.489 --> 00:37:57.630
some? I've never heard that about Vietnam or

00:37:57.630 --> 00:38:02.750
the 60s. Or the 60s. It was created as an anesthetic

00:38:02.750 --> 00:38:04.670
that they could give to each other. And it was

00:38:04.670 --> 00:38:06.650
so safe. And then they started discovering that

00:38:06.650 --> 00:38:09.489
people were actually, they had improved moods.

00:38:09.489 --> 00:38:11.090
It helped with their trauma and things like that.

00:38:11.389 --> 00:38:13.489
And so then it developed from there. It's been

00:38:13.489 --> 00:38:15.489
around a long time. It really didn't start, I

00:38:15.489 --> 00:38:18.710
don't know. It's been around a long time. Which

00:38:18.710 --> 00:38:22.780
I guess, to your point, the... on label use as

00:38:22.780 --> 00:38:25.739
an anesthetic, which is how you use it usually.

00:38:27.860 --> 00:38:30.639
So yeah, it was a valuable battlefield anesthetic

00:38:30.639 --> 00:38:33.860
because it's not respiratory suppressing. Hemodynamics

00:38:33.860 --> 00:38:36.260
aren't really affected. Your blood pressure actually

00:38:36.260 --> 00:38:38.820
goes up a little, and heart rate go up a little.

00:38:38.920 --> 00:38:41.239
I think that's more from a catecholamine release

00:38:41.239 --> 00:38:47.139
from the experience can be very intense. So yeah,

00:38:47.159 --> 00:38:51.340
it's safe in that respect. It's more chemically

00:38:51.340 --> 00:38:56.300
similar to like phenocycline, like PCP. Well,

00:38:56.579 --> 00:39:02.239
that's a different one. They've met, they maybe

00:39:02.239 --> 00:39:04.960
have rhinestone pants, but they're not the same.

00:39:06.940 --> 00:39:12.039
Different heights. I think from my side, from

00:39:12.039 --> 00:39:14.239
the therapeutic side of why I would say six is

00:39:14.239 --> 00:39:16.460
a good number, not getting into any of the nerd

00:39:16.460 --> 00:39:22.170
stuff, would be Six is a great number for me

00:39:22.170 --> 00:39:24.530
to see, like, is this helping with their depression?

00:39:24.730 --> 00:39:26.530
Is this helping with their anxiety? Is this helping

00:39:26.530 --> 00:39:29.510
with their suicidal ideation? Are we able to

00:39:29.510 --> 00:39:32.969
get into things, you know, into the trauma? And

00:39:32.969 --> 00:39:36.730
what I think it helps people is feel safe. So

00:39:36.730 --> 00:39:39.230
that this is just from the therapist side of

00:39:39.230 --> 00:39:42.030
like creating safety in your body and in your

00:39:42.030 --> 00:39:45.230
nervous system so that we can start to talk about

00:39:45.230 --> 00:39:47.389
the hard things that they couldn't get to before.

00:39:47.949 --> 00:39:51.280
And so If someone's done six and nothing's happened,

00:39:51.519 --> 00:39:52.820
I'm not going to tell them to throw good money

00:39:52.820 --> 00:39:56.099
after bad. This is pretty cost prohibitive. And

00:39:56.099 --> 00:39:57.880
that's where there's a little bit of safety with

00:39:57.880 --> 00:39:59.340
this. If you're not getting it off the street,

00:39:59.420 --> 00:40:01.840
it's like most people can't afford to get addicted

00:40:01.840 --> 00:40:04.340
to ketamine the way we do it. There is a little

00:40:04.340 --> 00:40:05.920
bit of safety if you have to come to the clinic

00:40:05.920 --> 00:40:12.019
and you do it. I think in regards to... So for

00:40:12.019 --> 00:40:16.599
me, if it's six, they haven't... Most people

00:40:16.599 --> 00:40:18.400
that they try six they're gonna experience something

00:40:18.400 --> 00:40:19.739
we're gonna experience some they're gonna be

00:40:19.739 --> 00:40:21.840
some change you're gonna see a change I would

00:40:21.840 --> 00:40:23.920
never say a hundred percent some people do six

00:40:23.920 --> 00:40:27.059
and they go but I It rarely happens where someone's

00:40:27.059 --> 00:40:29.150
really like doing it, they're not going to see

00:40:29.150 --> 00:40:33.110
something. So for me, just my measurement for

00:40:33.110 --> 00:40:35.010
whether it's working is, did they see, you know,

00:40:35.090 --> 00:40:37.250
we'll check in with that. Here's the category.

00:40:37.369 --> 00:40:40.829
Yes. And how have you improved, normalized your

00:40:40.829 --> 00:40:44.570
experience? Yeah. And then what we do is have

00:40:44.570 --> 00:40:46.929
them take a little holiday. I ask them to check

00:40:46.929 --> 00:40:49.289
in, like, what are you, people know their signs

00:40:49.289 --> 00:40:51.449
and their symptoms. What are the things, all

00:40:51.449 --> 00:40:53.150
those thoughts that keep me up at night, the

00:40:53.150 --> 00:40:56.340
stories that take over, the the not sleeping,

00:40:56.800 --> 00:41:00.059
the whatever it is. And then I tell them to check

00:41:00.059 --> 00:41:04.239
in for like what, when you notice your signs

00:41:04.239 --> 00:41:06.840
and symptoms coming back, come do a booster.

00:41:07.519 --> 00:41:10.300
Don't get, don't come down here to rock bottom.

00:41:10.650 --> 00:41:12.590
you start to see some of your stuff and then

00:41:12.590 --> 00:41:14.429
you go in for a booster and that will generally

00:41:14.429 --> 00:41:16.469
keep them going for a few more months. Everybody's

00:41:16.469 --> 00:41:18.969
so different. Some people will do like come in

00:41:18.969 --> 00:41:22.150
maybe four or five times a year after that initial

00:41:22.150 --> 00:41:24.929
six but sometimes people, we're not trying to

00:41:24.929 --> 00:41:28.210
keep you forever coming in for ketamine. We want

00:41:28.210 --> 00:41:31.190
to like have them go further and further. Oh,

00:41:31.190 --> 00:41:34.489
you know, but somebody might do an initial six

00:41:34.489 --> 00:41:36.469
and then I'm going to come every other week and

00:41:36.469 --> 00:41:38.070
then I'm going to come every fourth week. And

00:41:38.070 --> 00:41:41.010
then so taper, you know, like, yeah. And sometimes

00:41:41.010 --> 00:41:44.190
people are like, oh, the October is hard for

00:41:44.190 --> 00:41:45.969
me. I'm going to come in in October. Well, I

00:41:45.969 --> 00:41:49.710
do it twice at least twice a month for because

00:41:49.710 --> 00:41:55.219
I have PMDD, which means like. During 10 days

00:41:55.219 --> 00:41:58.679
before my period. It's just I'm different. I'm

00:41:58.679 --> 00:42:02.079
depressed I'm dreadful black and white thinking

00:42:02.079 --> 00:42:05.239
that's when I know it's kicking in and polarizing

00:42:05.239 --> 00:42:09.679
like there's no reason to Be this way except

00:42:09.679 --> 00:42:13.320
for what whatever like I guess my brain is reacting

00:42:13.320 --> 00:42:16.159
to the dip in hormones So I will schedule I'll

00:42:16.159 --> 00:42:19.659
try to schedule it 10 days before and then three

00:42:19.659 --> 00:42:23.929
days before and I mean Technically you could

00:42:23.929 --> 00:42:26.570
say, but why aren't you healed from PMDB after

00:42:26.570 --> 00:42:32.150
that? And chat should be T even said, not during

00:42:32.150 --> 00:42:36.710
your luteal phase, but like the 10th and third

00:42:36.710 --> 00:42:39.590
day before my period. And I know I have an appointment.

00:42:40.030 --> 00:42:45.250
I just need like one fucking break. Please. It

00:42:45.250 --> 00:42:49.829
just helps me feel relief and relief fast. And

00:42:49.829 --> 00:42:52.880
then it also kind of like. makes me realize like

00:42:52.880 --> 00:42:56.159
this is so temporary. Yeah, it's okay. Yeah.

00:42:56.500 --> 00:42:59.599
And so that's that's how I take care of my mental

00:42:59.599 --> 00:43:03.980
health. I feel like PMDD is quite a large thing.

00:43:04.300 --> 00:43:09.280
Yeah. Well, you summarized that very well. But

00:43:09.280 --> 00:43:12.920
the gravity of the feelings for PMDD, like not

00:43:12.920 --> 00:43:16.960
to be over descriptive or offensive, but this

00:43:16.960 --> 00:43:20.320
is the feeling that makes women kill their husbands

00:43:20.320 --> 00:43:22.800
and their children. So this feeling is profound.

00:43:22.880 --> 00:43:26.440
It is not subtle. It's not slight. This is something

00:43:26.440 --> 00:43:28.699
that is immense. Now, I'm not going to kill anyone,

00:43:28.699 --> 00:43:31.960
but I will admit that I like to watch a Doomsday

00:43:31.960 --> 00:43:38.719
movie. Apocalyptic events. Nice outlet. Like

00:43:38.719 --> 00:43:42.539
I just watch it, I don't feel it, yeah. So the

00:43:42.539 --> 00:43:45.639
way you paraphrased that was superb, but I feel

00:43:45.639 --> 00:43:50.050
like it really minimized. how intense that emotion

00:43:50.050 --> 00:43:54.949
can be. That's pretty profound. And then you

00:43:54.949 --> 00:43:57.530
said, just like the thought of being able to

00:43:57.530 --> 00:44:00.550
say, okay, I have this, that feeling of security

00:44:00.550 --> 00:44:02.909
that you have something that you can utilize

00:44:02.909 --> 00:44:09.570
to... Well, it immediately takes me out of whatever

00:44:09.570 --> 00:44:14.090
is going on in my mind. It's like my ADHD medicine

00:44:14.090 --> 00:44:18.349
doesn't work, my antidepressants. It's just bad

00:44:18.349 --> 00:44:22.090
and it immediately, like I'm talking about three

00:44:22.090 --> 00:44:25.550
minutes, gives me relief. And then I'm able to

00:44:25.550 --> 00:44:28.610
go home and just be like, it's like all these

00:44:28.610 --> 00:44:31.369
things that are spinning through my head, it's

00:44:31.369 --> 00:44:35.300
not. Big deal. It's temporary. Well, you've got

00:44:35.300 --> 00:44:37.139
to get through like you're gonna get through

00:44:37.139 --> 00:44:40.619
it. It's a perspective Yeah, it's just like it

00:44:40.619 --> 00:44:42.179
doesn't really calms your nervous system. Don't

00:44:42.179 --> 00:44:44.099
say that you can because you can know all these

00:44:44.099 --> 00:44:47.460
things but to actually feel it is so different

00:44:47.460 --> 00:44:55.980
Unclencher. Yeah I mean also like I do way other

00:44:55.980 --> 00:44:59.019
things yeah during a variety of different things

00:44:59.019 --> 00:45:02.539
like I I won't make too many plans the progesterone

00:45:02.539 --> 00:45:05.860
I go up a hundred milligrams which really helps

00:45:05.860 --> 00:45:10.960
and then just so much grace and compassion and

00:45:10.960 --> 00:45:13.360
and dog cuddles and then I have to remind myself

00:45:13.360 --> 00:45:16.739
like it's temporary yeah so you're like this

00:45:16.739 --> 00:45:20.199
too shall pass over like no you know if anyone

00:45:20.199 --> 00:45:24.239
has the magic pill out there I'm ready. Send

00:45:24.239 --> 00:45:27.320
it over. She's like, I'm ready. That's the thing

00:45:27.320 --> 00:45:30.500
to remember about ketamine is it is a tool. It's

00:45:30.500 --> 00:45:33.860
a power tool, but it's a tool. And this, along

00:45:33.860 --> 00:45:37.300
with the other things like that you just mentioned,

00:45:37.800 --> 00:45:42.199
you know, therapy, movement, exercise, eating

00:45:42.199 --> 00:45:45.860
healthy. I mean, all those things are, ketamine

00:45:45.860 --> 00:45:48.179
alone probably isn't gonna just fix everything.

00:45:48.320 --> 00:45:51.670
I mean, it won't. It won't. And so just remembering,

00:45:51.909 --> 00:45:54.289
it's just a tool, but it's a really good tool.

00:45:54.349 --> 00:45:56.809
Can I take this if I'm pregnant or breastfeeding?

00:45:58.090 --> 00:46:00.670
Not pregnant. I was against it if you're pregnant.

00:46:01.289 --> 00:46:02.949
I mean, I don't know. I think they've changed

00:46:02.949 --> 00:46:05.590
the pregnancy categories, but I think it's pregnancy

00:46:05.590 --> 00:46:10.389
category C or was. I don't know. I haven't worked

00:46:10.389 --> 00:46:15.119
in. But yeah, so we advise against it. No, that

00:46:15.119 --> 00:46:18.039
means no. But breastfeeding. You just have to

00:46:18.039 --> 00:46:21.559
be upset a little and sad. Yes. Pump and dump.

00:46:21.599 --> 00:46:23.760
Pump and dump. Because it's a three hour half

00:46:23.760 --> 00:46:27.179
life. Exactly. Yeah. So it's good for people

00:46:27.179 --> 00:46:30.900
with PMDB. Yeah. Postpartum. Postpartum. Because

00:46:30.900 --> 00:46:34.420
they can get help really fast rather than waiting

00:46:34.420 --> 00:46:36.260
six weeks for that kind of depression to kick

00:46:36.260 --> 00:46:39.630
in. They just pump and dump. those those meds

00:46:39.630 --> 00:46:42.449
too are also category c but right i would still

00:46:42.449 --> 00:46:47.409
just the unfortunately i i wouldn't want to um

00:46:47.409 --> 00:46:51.369
well this isn't medical advice this is just discussing

00:46:51.369 --> 00:46:54.590
who Can use ketamine and you still would have

00:46:54.590 --> 00:46:57.369
to talk to your doctor. You would still have

00:46:57.369 --> 00:46:59.889
to consult a professional. You don't want to

00:46:59.889 --> 00:47:02.750
freestyle it. Make sure you ask Jack GPT about

00:47:02.750 --> 00:47:09.190
it. No, no, no, no. Use Jack GPT as something

00:47:09.190 --> 00:47:13.570
to do while you're in the bathroom. Don't pretend

00:47:13.570 --> 00:47:22.739
like he has hands. I would just say yes. Damn,

00:47:23.219 --> 00:47:28.099
Bob. Whitney, quit it. What the fuck? Yeah, just

00:47:28.099 --> 00:47:31.219
generally if pregnancy would encourage them to

00:47:31.219 --> 00:47:33.480
pursue conventional treatment until they're...

00:47:33.480 --> 00:47:36.099
Until they're delivered. Well, that's good. That's

00:47:36.099 --> 00:47:39.639
good to know. I feel like you guys are kind of

00:47:39.639 --> 00:47:44.300
special and great. I've seen a lot of people

00:47:44.300 --> 00:47:50.559
transform with ketamine. It's cool. Yeah, it's

00:47:50.559 --> 00:47:53.960
very special. To be able to facilitate that in

00:47:53.960 --> 00:47:57.699
somebody's life is a pretty big deal. I love

00:47:57.699 --> 00:48:00.380
it. I mean, it's something I'm quite passionate

00:48:00.380 --> 00:48:03.519
about. I believe in it. I see it work. I experience

00:48:03.519 --> 00:48:07.519
it myself, and I get excited too. I've seen a

00:48:07.519 --> 00:48:09.760
lot of friends be helped, but it's been really

00:48:09.760 --> 00:48:13.670
remarkable to see. where you've started and where

00:48:13.670 --> 00:48:16.409
you've come from, like where you've come from

00:48:16.409 --> 00:48:19.889
and where you've arrived. Thank you. I've got

00:48:19.889 --> 00:48:23.409
a team of good people. Yeah, but it's really,

00:48:23.429 --> 00:48:26.510
it's pretty special. I'm very proud of you. Good

00:48:26.510 --> 00:48:32.389
job. Well, I don't have any more questions. Do

00:48:32.389 --> 00:48:36.340
you? I don't think so. I'm so glad you guys came.

00:48:36.420 --> 00:48:39.559
Now I know a little bit. Yeah. We can refer people

00:48:39.559 --> 00:48:41.559
because we have a lot of people that come in

00:48:41.559 --> 00:48:45.900
here for a wrinkle that's not, it's not a wrinkle.

00:48:46.099 --> 00:48:49.280
It's something in your soul or your heart, you

00:48:49.280 --> 00:48:51.019
know, and they're like, what if we fix this?

00:48:51.019 --> 00:48:54.099
And I'm like, oh, my beautiful woman, let's get

00:48:54.099 --> 00:48:56.340
you some estrogen and progesterone and let's

00:48:56.340 --> 00:48:59.360
have a ketamine adventure and then make sure

00:48:59.360 --> 00:49:01.099
that this is still something you want to do.

00:49:01.239 --> 00:49:04.380
because we really want people to be here for

00:49:04.380 --> 00:49:07.699
an ethical reason, not to fix something that's

00:49:07.699 --> 00:49:11.019
not there. Well, and perhaps you maybe need support

00:49:11.019 --> 00:49:14.179
with something and there's other aspects of your

00:49:14.179 --> 00:49:18.340
life that need support. Botox is beautiful, but

00:49:18.340 --> 00:49:22.320
it doesn't wrinkle out your heart. Yeah. It doesn't

00:49:22.320 --> 00:49:25.199
doesn't doesn't do those. A heart wrinkle. Those

00:49:25.199 --> 00:49:28.179
are hard to get out. I don't fuck with those.

00:49:28.960 --> 00:49:33.039
Too hard. But yeah, it was so nice to meet you.

00:49:33.059 --> 00:49:35.400
Nice to meet you too. Thank you so much. We appreciate

00:49:35.400 --> 00:49:35.579
you.