Brooklyn Heights doctor promotes alternative therapies for depression, by Peter Haley

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A commercial real estate agent in his mid-30s, Jerry took ketamine – a so-called psychedelic drug typically more associated with kids in clubs than businessmen – as a therapy to treat his lingering depression. And according to him, it works better than anything Jerry’s has tried.
In cognitive behavioral therapy for a while, he had also been introduced to Lexapro, an SSRI antidepressant like Prozac and Zoloft. It worked to some extent, but was not satisfied. “While that softened me, the side effect was to take away my advantage, my ability, my desire to do creative work, which I need for my writing, my music,” said Jerry who aspires to produce music. softened me, made me settle for relaxation. I was happier, yes, but the ability to push myself and focus to take it to the next level just wasn’t there.
Many who seek treatment for persistent depression find popular drugs largely ineffective.
They talk about their dropout, taking them to a neutral space as they battle their depression. And so some choose a shortcut – ketamine therapy – to speed up the healing process.
What Jerry sees is part of a booming new wave of psychotherapy; repositioning anesthetic and psychedelic drugs to treat depression, post-traumatic stress disorder (PTSD) and similar mental illnesses.
But while clinical trials with LSD, psilocybin, and other hallucinogens are underway for the treatment of such conditions, they have yet to be approved.
But ketamine, a little-understood drug that’s a standard anesthesia protocol in hospital emergency rooms, is already here, with medical treatment centers sprouting from Long Island to Los Angeles. The American Society of Physicians, Psychotherapists, and Ketamine Practitioners now represents some 400 members.
Yet you wonder, wait a minute, isn’t ketamine also an animal tranquilizer, a so-called “club drug?”
Well, yes, somewhat guilty, but, ultimately, his ability to create altered dissociative and sometimes hallucinogenic states can also set the stage for significant personal behavior changes. Ketamine induces dissociative anesthesia, a trance-like condition providing pain relief, sedation and amnesia
Experts believe that ketamine treatment may temporarily alter the psyche of these stalled patients and lead to transformative change.
“Since the 1970s, ketamine has been a standard of care for the treatment of patients in operating rooms and emergency departments across the country,” says Dr. Nicolas Grundmann, a physician trained in emergency medicine. based in Brooklyn.
He is the co-founder and chief medical officer of Ember Health, a mental health treatment center located on Court Street that administers intravenous (intravenous) ketamine for depression.
He describes ketamine as “a well understood drug” in the medical community, “Over 300 randomized controlled clinical trials conducted over the past 20 years have demonstrated the effectiveness of IV ketamine for depression.”
Grundmann pointed out that the use of ketamine for depression is not a “Hail Mary” approach because “clinical trials have been conclusive, showing 75% efficacy in patients with treatment-resistant depression.
Indeed, he says, “83% of our customers at Ember Health are successful in relieving their depression.”
Based on its positive results, IV ketamine has been approved as a treatment by the American Psychiatric Association of America.
“The current debate is not around ‘does this work?’ but rather how best to use this tool to help people? Explains Grundmann, “When administered in a safe and medically supervised environment, IV ketamine allows people with depression to reset their emotional reward system.
While traditional antidepressants numb their feelings, patients describe ketamine as helping them feel more about themselves.
How is this change possible? Let’s take a look at psychedelics and ketamine to start.
Psychedelics induce a state of supersaturation, both stimulating and perceptual of the senses.
Conversely, ketamine is dissociative, a chemical that causes a state of under-saturation of the senses and their perception, and in this void clients can attain a mystical state of insight.
While psychedelics work by relaxing the inhibitory architecture of the brain, flooding the senses. Ketamine stops this.
Jerry describes his ketamine sessions as a “very introverted experience, but also like your mind is flying, flying, it’s hard to describe.”
But he also believes that continuation of conventional therapy is still necessary because “a large part of the gains result from taking advantage of the relative elasticity of the brain after a ketamine infusion to create new neural pathways. You want to grow up on it.
Dr. Grundman calls this elasticity “adaptive learning, deliberately trying to change your thoughts and work it out with your therapist.” ”
Therapy to Work is part of a network of some 500 New York-area professionals connected to Ember Health. Dr Grundmann emphasizes that ketamine treatment does not replace conventional psychiatric therapy or the therapist, but rather improves the chances of recovery.
Ember sessions last 90 minutes – The drug treatment itself lasts 40 minutes, with 15 to 20 minutes of preparation, leaving 30 minutes for “tea and debrief”.
Patients are lying on a sofa blindfolded to enhance the effect. Clients can verbally record their thoughts or write them down after the debriefing.
Treatment may involve aromatherapy, music therapy (with headphones) to help enter the “altered state” of the infusion. Most of Ember’s patients will experience “shifts” in insight and perspective reflecting the altered state situation caused by ketamine, explains Dr. Grundmann,
“Most of our patients have a dreamlike view of the experience, not so much out of the body or hallucinogenic.
The real effect is how a person feels, making them more introspective, more meditative. ”
Ember Health is located at 26 Court Street in downtown Brooklyn.


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