River Oaks clinic Field Trip Health brings ketamine-based therapy to depression treatment

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Field Trip Health is not an ordinary clinic.

Opening on May 10, the River Oaks facility will house Houston’s next ketamine-enhanced psychotherapy clinic. Here, patients can take psychedelic therapy in a space designed just for it. It’s located at 4310 Westheimer Road, Suite 220.

While Ketamine is currently a schedule III drug under the Controlled Substances Act and is approved for use in hospitals and other medical settings as an anesthetic, FTH administers a ketamine-derived nasal spray drug called Esketamine that recently earned FDA-approval for those with treatment-resistant depression.

Esketamine is already used by some medical professionals to treat depression outside of a therapeutic environment. It provides rapid results, said Dr. Asim Shah, the executive vice chair of psychiatry at Baylor College of Medicine.

“Esketamine is not off label,” Shah said. “Esketamine is FDA approved. It was approved about one and a half years ago... The use is restricted because of the cost. The monthly cost is $8000, (so) you can imagine insurance is not gonna approve it, right? Or will be reluctant in approving it.”

FTH is only providing ketamine-assisted therapy at this time and is currently operating in Toronto, New York, Los Angeles, Chicago, Atlanta and now Houston.

According to FTH’s website the cost of treatment is dependent on the total amount of sessions FTH recommends. The first module of the program, which includes consultations, preparations and exploratory sessions costs $2,400. An additional modular may cost around $1,750.

“Our mission is to bring the world to life through psychedelics and psychedelic-assisted therapies,” said FTH Founder Ronan Levy. “Because when you look at the evidence around psychedelics, they have profound abilities to offer treatment options for people dealing with mental health conditions like depression, anxiety, PTSD, eating disorders… But the primary research right now is in depression and PTSD.”

Developing new options

As a company, FTH has two primary divisions — Health, which is building the clinical infrastructure to deliver psychedelic therapies, and their Discovery division, which is focused on drug development and research.

According to Levy, as potent and effective as ketamine derivatives, psilocybin, or MDMA-assisted therapy can be, which is where most of the research exists right now, it doesn’t mean the company can’t develop new molecules and drugs that address some of the limitations associated with psychedelics.

One limitation a new molecule could potentially address is the extended duration of a psychedelic experience that makes it clinically expensive and difficult to administer. The company is in pre-clinical trials for a novel psychedelic molecule called FT--104 that is similar in potency to psilocybin but with a shorter duration of psycho-activity, making the molecule a potentially the preferable option for psychedelic therapies.

“If you can shrink that timeframe without changing the efficacy, then it becomes a really effective medicine for us,” said Levy.

‘Not your average clinic’

The clinics put a lot of attention into their setting, which is designed to foster feelings of nature and childlike wonder and help people feel relaxed with a sense of curiosity and humor.

“It’s not your average clinic, I would say that,” said Dr. Ben Medrano, Senior Vice President and Medical Director at FTH.

The staff at FTH try to contribute to that feeling as the company seeks employees who are not only passionate and dedicated to psychedelic work but who are empathetic by nature. FTH also attempts to represent the society they serve, which means they have a diverse staff in ethnicity, skill sets, life experience and background.

FTH received a Google review that described the clinic as “spa-like," but Medrano has mixed feelings about that characterization because, to him, it may make it seem like they don’t take their work as seriously as they do.

“We just don’t have that clinical edge in terms of the ambiance,” said Medrano, who works at one of FTH's New York clinics. “We are very much prepared for any kind of challenging outcome that may occur.”

All of the clinic’s rooms are fully equipped with things one would only find in a psychedelic clinic: noise canceling headphones, blackout masks, adjustable zero gravity chairs, weighted blankets and the themes of the rooms all differ in terms of nature tones.

In some clinics they have sound systems that are completely tailored to psychedelic medicine, with programs that allow therapists to select music based on what the most appropriate tone for the patient’s life story, their background, and whatever active issue they’re working on. The therapists may also speak through a microphone that goes directly in a patient’s noise-canceling headphones to guide them and make them feel safe.

Many clinics also have what FTH calls integration spaces, where patients can go after they finish treatment to reflect on their experience, with the option to meditate, do yoga, color, draw and journal.

Complex history

“No doubt that ketamine is also known as “Special K” and it’s been a club drug and it has been used as a date rape drug just as MDMA has,” said pharmacologist and co-host of The People’s Pharmacy public radio program, Joe Graedon, “but the bottom line is, if it’s used by a skilled clinician who knows what they’re doing for anesthesia, the drug can be used successfully.”

According to Medrano, ketamine being used as an anesthetic in an operating room has very few risks and has been listed on the World Health Organization’s Essential Medicines List since 1985. When FTH uses it in one of their clinics as a psychedelic, they use about 10 times less than what is used in an operating room.

“Most of the safety research that’s been done on ketamine has been done on people taking whopping doses of ketamine, compared to what we’re doing now,” said Medrano.

However, nausea and vomiting are common side effects of ketamine, according to Medrano, but are addressed quickly with anti-nausea medication. Sometimes patients also get headaches that are easily treated with Tylenol.

There are rare instances of patients being allergic to ketamine or someone’s airways becoming swelled, but FTH said they have not experienced this in any of their clients.

For people who regularly abuse ketamine, they generally see bladder inflammation.

“Just like with any drug, there’s a long list of potential things that could occur,” said Medrano, “but surprisingly, with ketamine, it’s a very short list, and it’s very rare.”

Addressing the stigma

Levy believes that the stigma around psychedelics will begin to fade. As more data becomes available that examines the safety and efficacy of psychedelic therapies, he believes the stigmas will naturally evaporate.

Before the stigma goes away, however, there are things they do to help.

“Getting rid of the stigma starts with education,” said Medrano.

Due to the amount of misinformation about psychedelics in past decades, medical professionals in the field were digging themselves out of a hole when it came to psychedelic research, he said.

“Volumes of psychedelic research that had occurred in the 50s and 60s had been sort of forced to the back of the bookshelves and not taught in any kind of training programs or talked about in the mental health research field all that much,” said Medrano. “It just became a fading memory.”

Research into psychedelics as a credible medicine started progressing in the 1990s with research on similar drugs, such as dimethyltryptamine, said Medrano.

Now, there is a swell of research coming out of multiple respected sites, including the John Hopkins Center for Psychedelic & Consciousness Research, NYU, Mount Sinai, Columbia, and Cornell, to name a few. Even former Republican governor Rick Perry also recently pitched the study of psychedelic drugs for PTSD in veterans at the Texas Capitol, who admitted to historically being a “very anti-drug person”.

The research by respected institutions contributes to the validation of psychedelic research among medical professionals. Talking to the public about how safe it is helps remove the stigma for people who didn’t go to medical school.

“For the most part, psychedelics, especially under clinical supervision, are extraordinarily safe,” said Medrano. “And people don’t realize that because they thought that maybe it might damage your DNA or this other stuff that got propagated back in the 70s and 80s.”

To address the stigma of psychedelic therapy even further, Levy hosts a podcast called the Field Tripping Podcast, which explores how psychedelics awaken new views on sex, science, business, fitness, life, and death. They speak with medical and other professionals who speak to how psychedelic therapies have enhanced the quality of their lives or helped them face the issues or challenges that they’ve experienced.

“What really got me excited about psychedelics in the first place is, I got this deep sense that even though we talk about mental health and try to have a very open minded approach these days, it still really is couched in an attitude of reactivity,” said Levy. “People seek mental health treatments only when it gets to extreme circumstances of depression or anxiety on a clinically diagnoseable basis.”

If people start thinking about mental health the way people think about going to the gym, which is, is they’re proactive about it, it could open a new category of the conversation around mental and emotional health and well being, making psychedelics seem more approachable, said Levy.

Levy says that as people get more comfortable talking about working with their mental and emotional health, psychedelics are going to become a viable treatment option- he even expects it to become a preferred treatment option because, according to Levy, many people have a positive experience while having a psychedelic experience. They’re able to visit and process traumatic experiences and come out the other end with meaning, which is positive, said Levy.

“Most of our investors early on were people who had positive experiences with psychedelic therapies and so it really continues to advance by itself because of the profundity and the efficacy of these treatments,” said Levy.

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