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As ketamine clinics emerge to treat mental illness, so does debate about safety and regulations

Akash Pasricha, The Seattle Times on

Published in Business News

SEATTLE — In a spalike clinic overlooking Lake Union with moss walls and floor pillows, Bridget Carnahan treats patients for mental illness with blindfolds, noise-canceling headphones, talk therapy, and a psychoactive drug called ketamine.

Carnahan is the director at a Westlake clinic opened last month by Field Trip Health, a Nasdaq-listed company selling medically supervised "psychedelic journeys." She calls ketamine therapy a "new frontier" for understanding mental illnesses.

In the past three years, at least a dozen such facilities have popped up around the Puget Sound region.

"When we started seeing patients a little more than a year ago, I wasn't sure what to expect in terms of volumes," said Liana Ren, a nurse anesthetist who runs Lighthouse Infusions, a ketamine clinic in Kenmore. "The last couple of months ... our schedule has been full."

Ketamine, typically used as an anesthetic during medical procedures, is not approved by the Food and Drug Administration for treating mental illness. Frequent use can lead to addiction. Research suggests long-term side effects of repeated ketamine doses are uncertain.

But studies suggest that when administered correctly and under strict, medical supervision, the drug may help alleviate symptoms of severe depression, post-traumatic stress disorder (PTSD) and anxiety in some people.

 

Treatments don't always work. Even with repeated doses, some research suggests patients may relapse within two to three weeks. Certain psychotic disorders and cardiovascular diseases make patients unsuitable candidates for the drug.

"This offers great hope ... but we can't let our optimism and excitement about this get ahead of the data that we have on the safety and efficacy," said Dr. Gerard Sanacora, co-director of the Yale New Haven Hospital Interventional Psychiatry Service.

Clinics are mostly run by advanced nurses, which has stirred debate. Nurse anesthetists work with ketamine regularly during medical procedures, and psychiatric nurse practitioners are licensed to administer the drug. However, some psychiatrists express concern that medical doctors are often not directly involved in treatment.

There are also medical and legal concerns around remote companies that don't run clinics but rather mail patients ketamine lozenges and treat them over video chat. Asked about these remote treatments, Sanacora said, "there is zero high-quality data to show that that is safe or effective ... period."

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