Name: Ketamine, Long-Stigmatized, Becomes a Booming Mental-Health Treatment
Uploaded: 2022-09-12T09:30:00Z
Duration: 7 min 59 s
Description: Clinics specializing in ketamine treatment for depression and other mood disorders have popped up across the U.S. in recent years. WSJ visits one clinic to learn why some entrepreneurs are betting that demand for ketamine will continue to rise. Photo illustration: Laura Kammermann

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Clinics specializing in ketamine treatment for depression and other mood disorders have popped up across the U.S. in recent years. WSJ visits one clinic to learn why some entrepreneurs are betting that demand for ketamine will continue to rise. Photo illustration: Laura Kammermann

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Ketamine, Long-Stigmatized, Becomes a Booming Mental-Health Treatment 

The market for ketamine, I think is rapidly expanding.

This is a seismic shift in the way people with mood disorders will be treated.

Narrator: Over the past few years, hundreds of clinics specializing in ketamine treatment for depression, anxiety, and PTSD have popped up across the country, and some investors see potential, pouring hundreds of millions of dollars into ketamine-related startups.

This, I think, is the new generation of medicine.

We're really changing the face of psychiatry.

Narrator: So, how big is the market for this psychedelic treatment? Who are the biggest players? And could the spread of this alternative therapy impact the market for traditional antidepressants? Originally synthesized in 1962, ketamine is a powerful short-acting anesthetic. The drug's first widespread use was during the Vietnam War where it was used to treat injured soldiers. In 1970, ketamine became a popular general anesthetic after the FDA approved it for children and the elderly. The DEA classifies ketamine as a Schedule III non-narcotic, which means that it has moderate to low potential for physical and psychological dependence. The antidepressant properties of ketamine remained relatively unknown until Yale University released a study in 2000.

And what the study showed is that the effect was taking within a few hours, and it was going into full effect within 24 to 72 hours after treatment.

Narrator: Dina Burkitbayeva's venture fund, PsyMed Ventures, has raised $25 million and invested $17 million of that into 14 psychedelic startups. PsyMed also tracks data related to ketamine clinics.

We're estimating the market for ketamine clinics right now at $1 billion, and in the next five years, we see potential for it to 2-3x.

Narrator: Although ketamine was shown to be effective in treating depression by 2000, it wasn't until 2019 when the number of ketamine clinics began taking off.

We estimate that in 2019, there were approximately 15 to 20 ketamine clinics that were providing mental health treatment. Fast forward to 2022, there's over 400 clinics.

Narrator: In 2019, the FDA approved a compound related to ketamine called esketamine for treatment-resistant depression.

Announcer: Today, we usher in a new breakthrough therapy in major depressive disorder.

Esketamine, which is marketed under the brand name Spravato, is a nasal spray that patients self-administer under a doctor's supervision. Ketamine is made up of a pair of compounds, S-ketamine and R-ketamine, that are like mirror images of each other. Whereas ketamine can no longer be patented, these two component compounds can be patented, which is why the pharmaceutical company Janssen was able to turn S-ketamine into a marketable drug. Today, there are several different types of businesses that specialize in ketamine therapy. The most common are smaller practices run by doctors or therapists. For patients who would prefer to avoid traveling to a clinic or office, there are virtual ketamine clinics, like Mindbloom or Nue Life. These startups allow ketamine to be prescribed and sent to patients via telehealth. Lastly, there's larger clinics like Field Trip Health or Ember Health. One of the newest larger clinics is Nushama, which opened its flagship location on Manhattan's Park Avenue in October, 2021.

When people walk in from the chaos of the streets of New York, we want people to have their anxiety drop. We also want them to feel extremely safe, but not in the context of feeling like a cold, hospital-like environment.

Narrator: Nushama calls itself a psychedelic wellness center, not a clinic, and it refers to its clients as members, not patients. All prospective Nushama members receive a medical and psychiatric evaluation from a Nushama doctor or nurse to determine if ketamine treatment is right for them. Nushama says it turns away about 10% of potential patients if they have a substance abuse problem, untreated psychiatric conditions, or certain medical conditions, like high blood pressure and heart disease. Once approved, a typical treatment for an individual runs about $4,500. That includes six onsite, high-dose sessions, which are administered by board-certified anesthesiologists over three to six weeks.

We've reached profitability in less than a year's time, which is pretty unheard of for businesses, especially startups.

Narrator: Currently, Nushama has four locations in New York City. The company said it plans to scale up over the next five years and open an additional 35 clinics across the Northeast.

Why the Northeast? Roughly 60 million people in the Northeast alone. So, it's a wonderful opportunity and there's high rates of depression, anxiety, and other mood disorders here.

Narrator: And it isn't just Nushama, Field Trip said it plans to open 75 clinics across the country by 2024.

I wouldn't call it a gold rush, but I would call it a great opportunity.

Narrator: Billionaire entrepreneur, Adam Weitsman, is one of Nushama's earliest investors. Weitsman is the owner of Upstate Shredding, the East Coast's largest privately owned scrap metal processor and recycler. Nushama is his first investment in the psychedelic space.

I think it's a really profitable business. I think it's a strong cash flow business, and I think it's something that they can scale, you know, pretty easy.

Narrator: Revenue from US ketamine treatments has grown from $8.3 million in 2017 to $185 million in 2022. In 2020, an estimated 14.8 million US adults had at least one major depressive episode with severe impairment in the past year. And COVID-19 made things even worse. The global prevalence of anxiety and depression increased by 25% in the first year of the pandemic.

There's a tremendous demand for ketamine-assisted psychotherapy. I'm bombarded with recommendations, wishes for referrals for treatment. It's hard to keep up.

Narrator: Dr. Gita Vaid is a psychotherapist who runs her own ketamine-assisted therapy practice and teaches other therapists how to do the same.

Insurance companies typically do not cover ketamine-assisted psychotherapy because they haven't been enough studies comparing it as a treatment for major depression or treatment-resistant depression.

Narrator: Although there is substantial evidence that ketamine has powerful antidepressant effects, in order to be approved by the FDA, the drug would need to get through years of tests that would likely cost billions of dollars.

And so, this really limits access to the patients for this treatment. So it's a very small population that gets access to ketamine therapy today.

Narrator: It's important to note that esketamine is covered by insurance since it was approved by the FDA for treating depression. To reduce costs, some clinics are developing new treatment options. Nushama offers group therapy for $2,800, or just about half the price for its individual treatment. Nushama also has a 35% frontline workers discount.

Hopefully, at some point, insurance will play a part in helping people pay for the treatment. But I also think there's ways of us to make the experience less expensive and less costly by, you know, these are expensive addresses, we don't have to have the rents like this at every location. We can go to areas that their rents are less.

Narrator: Despite being bullish about the growth of ketamine treatment, none of the founders, investors, or clinicians we spoke with expected ketamine therapy to take a significant bite out of the traditional antidepressant market, at least anytime soon.

We are believers that SSRIs or antidepressants and benzodiazepines or anti-anxiety medications, they do have a role, they just don't work for everyone. So, our position at Nushama is, we're offering an alternative to that.

Investors Bet on the Promise of Ketamine for Mental-Health Care

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