How Does Psychedelic Teletherapy Work

The days of psychedelics and hallucinogenics being purely illicit chemicals utilized in nightclubs and underground circuits are long gone. In reality, psychedelic teletherapy may now be obtained from home to treat depression and other mental health disorders. How Does Psychedelic Teletherapy Work

With the legalization of marijuana, Americans’ views about these substances are changing, as is research demonstrating the potential for healing with several of these drugs, most notably psilocybin (mushrooms), MDMA (ecstasy), and ketamine (Special K).

Furthermore, while depression rates rise—by more than 25% during the pandemic alone—and an increasing number of Americans use antidepressants, less than half of people discover an antidepressant that works adequately for them on the first try.

What the Research Says

Other psychedelic research shows promise, including long-term symptom alleviation with psilocybin, but ketamine is now the only hallucinogenic permitted in the United States because it is also used as an anesthetic for surgery.

Ketamine is classified as a dissociative anesthetic, yet it can have hallucinogenic effects. Ketamine has been investigated in depth for depression since the late 1990s, with a 2000 report promoting its antidepressant qualities. Its greatest strength is the speed with which it operates.

One research found that persons who had a ketamine infusion in the emergency hospital in 90 minutes had a significant reduction in suicide thoughts, compared to the weeks that antidepressant medication may take.

Ketamine has been used off-label for depression since the early 2000s, but the nasal ketamine preparation Spravato was fast-tracked for FDA clearance in 2019 due to its potential.

Ketamine is often provided in a clinic, either via intravenous infusion or through the Spravato nasal spray—both of which need individuals to be examined during and after the experience to monitor for adverse effects such as nausea, high blood pressure, disorientation, and so on.

A therapist may be on hand at a ketamine clinic for an “integration” session after the “trip” to analyze what may have come up during the “trip” and discuss ways to integrate insights into the person’s life post-experience.

 Related post: What Is Psychedelic Therapy?

The Rise in Psychedelic Teletherapy

The coronavirus pandemic produced the ideal conditions for the birth of ketamine teletherapy: a substantially increased demand and awareness for mental health care services, a meteoric growth in telehealth services, and an easing of limitations to allow for the spread of telehealth services.

These new limits How Do Psychedelic Teletherapy Work clinicians use telehealth to prescribe banned medications like ketamine, whereas earlier laws prevented ketamine teletherapy unless the patient had previously been treated in person. Many people are advocating for the extension of these freedoms forever. Otherwise, these startups may be jeopardized.

Psychedelic Teletherapy Companies

While individuals provide ketamine teletherapy, the majority of the work in this field is done by a small number of venture-backed or publicly listed firms.

• Field Trip
• Ketamine One
• Numinous
• My Ketamine Home

Many of these businesses have polished presentation decks for investors promoting market potential—that is, the possibility for more individuals suffering from mental illness to generate money. Ketamine delivery via teletherapy is also specifically mentioned as a cost-cutting method to allow more patients to be visited.

How Psychedelic Teletherapy Works

Dr. Michael Verbora, Medical Director of Field Trip Health, spoke with us about their at-home ketamine method. To oversee the procedure, Field Trip has teamed with Nue Life, another ketamine startup that specialized in at-home ketamine.

According to him, patients first inquire about the process and then meet with Nue Life’s team. If they are accepted, they are given a single dosage of ketamine.

“They would log on, do a bunch of check-ins and monitoring and compliance with the ketamine,” he adds. They would go through their therapy, note any adverse effects or advantages, and then meet with a coach in the coming days.”

He describes two approaches to ketamine-assisted psychotherapy: “what we call the psychoanalytic way—where you take a really small dose and feel kind of normal but a little more lubricated to speak openly about your pain and suffering.” There’s also the high dose, when we urge individuals to go within and be alone.”

Each patient must have a “sitter” there to watch the patient, in case of adverse effects or if the patient need anything. The sitters are pre-trained and must display their faces on Zoom before the session begins. How Does Psychedelic Teletherapy Work

What Conditions Does Ketamine Help With?

Ketamine can assist with a variety of diseases, but it is most commonly used to treat treatment-resistant depression (depression that has not been meaningfully treated by other drugs). It may also assist with the following conditions:

• Post-traumatic stress disorder (PTSD)
• Chronic pain
• Anxiety disorders
• Bipolar disorder 
• Obsessive-compulsive disorder
• Suicidal ideation 

Ketamine, on the other hand, should not be used on persons suffering from schizophrenia or psychosis. Ketamine is physically contraindicated in pregnant women, persons with high blood pressure, severe liver dysfunction, major coronary artery disease, and serious drug abusers.

Although ketamine is frequently used to treat suicidality, Verbora states that “if we think someone is at high risk for suicide, we’re going to recommend a higher level of care or not doing ketamine at this time,” and that at-home ketamine will not be recommended for those patients.

Ketamine or other psychedelic medication may further exacerbate symptoms and discomfort in those who have experienced trauma or PTSD. Verbora will also not propose at-home ketamine for certain individuals.

The Future of Psychedelic Teletherapy

Field Trip Health is creating its own psychedelic, FT-104, and has applied for a patent on it. The psychedelic would function similarly to psilocybin, but with a two-to-three-hour experience rather than the three to six hours that psilocybin typically takes.

Verbora states that Field Trip intends to transition to additional psychedelics once they become available in the United States, but that he may not provide them immediately via telehealth because those experiences are often longer than an hour-long ketamine trip.

The data, on the other hand, is intriguing. One research found a strong antidepressant response in patients after just two sessions of psilocybin, and the findings were sustained at a six-month follow-up.

Is Ketamine Safe to Use at Home?

Ketamine was originally designed and used (and continues to be used) as an anesthetic, therefore it has certain drawbacks, including the chance of blood pressure rising by up to 50%.

The American Psychiatric Association issued a consensus statement on the use of ketamine in the treatment of mood disorders in 2017, guiding doctors on how to utilize ketamine.

This advice was focused on ketamine infusions, but acquiring a complete medical history, including lab findings, and being prepared for adverse events still apply.
Blood pressure increase and psychomimetic symptoms (those that resemble psychosis) are specifically included in the recommendations. The recommendations also urge being able to stabilize a patient in an emergency by administering oxygen or cardiac life support until the patient can be transported to the hospital. How Does Psychedelic Teletherapy Work

A Word From Verywell

While ketamine treatment for depression has been around for a while, the industry is still growing, and a 2018 investigation discovered major inconsistencies among brick-and-mortar clinics in terms of following the American Psychiatric Association recommendations, such as not thoroughly screening patients or having adequate medical and mental health staffing, as well as over-hyping the potential benefits of the treatment.

Because psychedelic teletherapy is still in its early stages, it’s critical to do your homework and ask plenty of questions before considering it as a treatment option.