Compounds and methods for treating severe psychiatric disorders are getting better and better…
Charlie sank into a chair in utter discouragement, as she realized she had awakened again, after hoping as she went to sleep that this would be her last night. Her last time to breathe. Night after night she prayed to die in her sleep. Morning after morning she woke up again. Ugh.
She felt betrayed by whatever cruel powers that be…that there seemed to be no compassion for her misery…and no escape.
She dragged herself to the bathroom and turned on the shower. Instantly, she saw an image of herself hanging by a rope from the shower head.
And she screamed.
Then climbed into the bathtub and stood sobbing under the shower.
Finally, she shampooed her hair, soaped up her body, rinsed, and turned off the water.
There was nothing to do but go to work…AGAIN…and try to function…AGAIN… and hopefully not get fired, because of her poor performance. Tears filled her eyes…
Suicidal Thoughts Can Be Deadly
Charlie is one of millions in the US who want to die as a result of depression. Approximately a million people commit suicide each year, and many times that amount try but survive. And many times more than those get struggle with suicidal thoughts that keep coming back.
Because relatively few tell anyone they’re thinking about or even considering suicide, it’s been impossible thus far to estimate the number.
They don’t want to die, they just don’t want to live with this kind of misery any more. Maybe you know someone like this… or you’ve felt like this yourself.
You are the ones we want to reach, to help, and to treat so you can rebuild fulfilling and rewarding lives again.
Ketamine Treatment Continues to be Misrepresented
With all its talents — with all its extraordinary mechanisms of actions — IV ketamine treatment may need a good PR firm!
When have you seen a safe, rapid, extraordinarily effective, life-saving treatment misrepresented, misunderstood, lambasted, and gossiped about more than ketamine? (Think about that for a minute.)
I saw a comment in STAT magazine the other day that took the cake.
There were lots of great comments, some more informed than others. But you do sort of expect that in a national publication. And… there was a lengthy comment–difficult to decipher–claiming ketamine was inherently dangerous.
It was clear the individual didn’t know about the research and data. All the information that’s poured out around the globe about ketamine and related compounds for psychiatric disorders over the last 10-15 years.
The commenter seemed to only be acquainted with its dangerous and highly abusable street form, Special K. And with the extremely high doses used on the streets… repeatedly over and over and often… he or she had seen the damage that abuse of ketamine can do.
As a psychiatrist, I hate to see it represented that way, but I cherish free speech, and freedom of expression. I also cherish scientific advancement and use it — every day — to relieve suffering.
Ketamine should definitely be administered under a psychiatrist’s close supervision, not self-dosed.
Then … there are the articles by young residents and clinicians, aspiring academics, and others. Those who have little true experience with the medicine or the treatment. But they’ve jumped in to write reviews of the literature or opinion pieces about it.
The best way to learn about ketamine treatment for psychiatric disorders is to hear directly from experts who actually use it — with many, many patients — every day in their offices or research units to treat psychiatric conditions. In this case, from the neuroscience researchers and psychiatrists who have worked with it a long time.
Because the truth is, the majority of physicians have read snippets about it here and there. They’re just now getting up to speed. And some have distorted ideas about it.
An article in VeryWell Mind by Naveed Saleh, M.D., May 2018, made some erroneous statements about ketamine treatment for suicidal thinking.
First, he claimed that ketamine is best absorbed through the intramuscular (IM) route, which is just simply false.
Ketamine is 100% bioavailable only when it’s given by the intravenous (IV) route. In IV form it’s delivered straight to the brain tissues that so desperately need its benefits. IM and IN (nasal spray), lozenges, troches, and oral liquids are all less bioavailable.
In addition, there are other problems with IM injections of ketamine that we’ve discussed and that are described in that Time Magazine article we talked about.
He also made claimed that if ketamine is to be widely-used, it most likely will be as an adjunct to other medications. Another misunderstanding of his research. Because the evidence says…
Ketamine Treatment Acts Independently of Other Medications
While that may or may not be true, my vote is that it won’t need to be. Evidence shows it doesn’t depend on other medicines for its mechanism of action. It’s not dependent on other medications to create a “partial response” that it augments. It acts independently on its own merits.
In fact, the most robust research is in patients where medication has FAILED — patients who have TRD, or treatment-resistant depression.
The left half of the ketamine molecule, known as esketamine, is nearing completion in its FDA trials and IS being tested as an adjunct to other medicines, not as a primary or stand-alone treatment. It’s being packaged as an intranasal spray, and has had some serious setbacks while seeking FDA approval.
It’s exciting to see what new glimpses researchers will find as they continue to study ketamine and other related compounds for treatment of suicidal thoughts, depression, bipolar depression, PTSD, OCD, social anxiety, and addictions. Maybe it will be a new action not yet identified, or maybe additional applications or conditions that could be responsive to this extraordinary treatment.
But the majority of patients who receive IV ketamine treatment report that other antidepressants or anxiolytics have failed, and, even if they walk in on antidepressants and mood stabilizers, they attribute their response and remission to ketamine treatment.
Ketamine Treatment of Psychiatric Disorders…
At Innovative Psychiatry, we see the majority of patients with severe treatment-resistant depression, bipolar depression, and suicidal thoughts. respond and achieve remission. They are real-life, real-world people just like you or people you know. Often, they don’t have just one thing or just one disorder — because psychiatric symptoms and disorders are complex and tend to run hand-in-hand.
We call that complex psychiatric cormorbidity.
Don’t let the term scare you.
It just means that when we see patients with treatment-resistant depression — as in unipolar depression and bipolar depression — they often also have other things, too, like social anxiety, PTSD, OCD, and addictions.
They’re often hopeless. Often suicidal.
It’s one of the reasons we’re so interested in following the research in using ketamine to treat suicidal thoughts and these other psychiatric conditions — and one of the reasons I write about them so often and devote space to them here.
Suicidal thinking can disappear within a few hours with IV ketamine treatment. Think about what that would be like for you … or someone you love.
If you’d like to consider ketamine treatment, give us a call. We can talk it through.
The Microbiome Has Been Underestimated
The microbiome is the collection of genes included in the trillions of bacteria, fungi, and viruses that populate the gut along nerve pathways connecting your brain to the rest of your body. These microorganisms provide our immune system and all work together to help our minds and bodies function properly and in partnership.
Another area psychiatry is advancing quickly forward is in its understanding of the importance of the microbiome and its effect on psychiatric illness.
When the balance between good organisms is outweighed by “bad” organisms, we become sick in some way. This may be an upset stomach, a systemic virus, or a disorder like depression, to name a few. Restoring the balance of these systems in our gut can help restore our health.
In fact, physicians have come to understand that sometimes the extensive use of antibiotics may destroy so much bacteria that the good bacteria that fights disease becomes depleted.
The more we learn, the more we can refine this essential part of our bodies to support our emotional well-being, as well as fight inflammation throughout our bodies.
But, we’re also learning it’s possible to overdo good organisms, too. And other disease symptoms can begin if there are far too many of them. It’s a balanced eco-system we’re looking for… We’ll be talking more about that soon.
Plans Unfolding for the 2019 Year Ahead
And we’re brimming at Innovative Psychiatry. (How’s that for 2019?) With new initiatives, new efforts, and exciting plans.
We’re expanding our hours and our availability, and preparing to publish our outcomes peer-reviewed journals in the hope of adding to the growing body of evidence of ketamine treatment’s remarkable benefits for treating an array of psychiatric disorders. (I’ll keep you posted as that develops.)
We hope to present our outcomes at more national and international conferences this year.
On top of that, we’re adding some opportunities to help us get more help to more of our patients to finance the cost of their treatment, and help fight for insurance companies to reimburse patients for the cost of their treatment.
Ketamine Treatment: Getting Better, Giving Back
Another opportunity in the wings is a program we’re developing — the first in the country– that would allow us to help patients Get Better and Give Back to their communities with special volunteer opportunities.
This program can help patients who would not have access to treatment any other way.
As we get all our irons in the fire scheduled and the details sorted out, we’ll update you so you’ll know what to watch for. G
2019 promises to be a year of hope, and a year of gratitude and goodwill, as we see more people feeling better... and getting well… after years of struggling without solutions.
We want to see progress made toward insurance companies covering ketamine infusions for psychiatric disorders. The medical billing code for ketamine infusions exist but it is usually rejected when it is linked to a psychiatric diagnosis. We continue to fight stigma and stigmatizing terms.
Hope is on the horizon. It’s going to be a good year.
If you battle depressive symptoms, or suicidal thoughts like Charlie, that haven’t gotten better, despite various medicines you’ve tried, please get in touch with us if you’re interested in ketamine treatment.
It consists of several doses of IV ketamine, usually about 6, and sometimes a few more, over 2-3 weeks. Ketamine isn’t appropriate for all patients — and doesn’t work as well for some as it does for most of our patients — so it’s not for everyone.
But we see such high percentages of response, we can say that most likely the chances are it will be a great help to you.
Most of our patients find after a full series of infusions, they can do things they’ve procrastinated about for years, enjoy things they used to enjoy, take advantage of energy to work, create, and socialize they had found impossible, in many cases for years. And build relationships and careers that are rewarding and satisfying.
We look forward to talking with you, and helping you find your smile again.
To the best YOU you can be in 2019,
