New clinic offers region's first psychedelic-enhanced psychotherapy practice
Patients take ketamine and then participate in a two-hour therapy session
A London, Ont., clinic is the first in southwestern Ontario to offer mental health patients therapy in conjunction with the psychedelic drug ketamine, which has shown promise in helping those with treatment-resistant depression.
Tatiana Zdyb, a clinical psychologist, is the owner of MindSetting, which started taking patients earlier this fall.
Zdyb said she spent the last year and a half developing a treatment plan using ketamine, but the pandemic's effects on her patients prompted her to open the new clinic.
"I was noticing a few months into the pandemic that 85 per cent of my patients were getting worse as a result of the pandemic," she said. "I knew I had to do something."
Ketamine is usually used as an anesthetic, sometimes in surgeries, and to treat severely suicidal patients in hospitals. It's also been used as a party drug, known as Special K, taken for its disassociative properties.
It can be taken orally, intravenously or intramuscularly.
Fewer negative thoughts
Zdyb works with her patients' psychiatrists or family doctors, getting them to prescribe a low oral dose of the drug. If the patients' doctor is uncomfortable doing so, she also works with Dr. Mike Hart, a doctor in London, but so far, hasn't come up against any pushback.
"I'm actually surprised at how willing these doctors have been to work with me," Zdyb said.
After a planning session, the patient takes the dose of ketamine in Zdyb's office, and about 15 minutes later the patient is more relaxed and uninhibited. A ketamine-enhanced therapy session lasts two hours, and is followed up with more sessions to discuss what was learned.
"Things that normally would cause people to censor themselves, to not be able to talk about certain things, the ketamine and other psychedelics dissolve that, so that we're able to bring to the surface things that wouldn't normally come to the surface," Zdyb said.
"Patients report things like, still having negative thoughts, but they're happening less frequently and, more importantly, their emotional reactivity to the negative thought is significantly decreased. It's like it changes the way that they experience their thoughts."
Patients must have no underlying medical conditions and have tried other therapies, such as antidepressants and traditional psychotherapy, without results.
Ketamine also offers another very important aspect of therapy, Zdyb said: hope.
"Hope is such an incredibly beneficial therapeutic tool, and I would even go as far as to say that hope is the greatest therapeutic tool that any psychologist has," She said.
"The ketamine really does create this hope. Some people, just knowing that this is an option helps then. They can say, 'Okay, there's something else that I can try and I might get a few hours of respite from my suffering,' and that in itself is therapeutic."
The only side-effects her patients have reported is mild anxiety the next day, which she and the patients plan for during an initial session.
"Usually, for part of the two-hour session, the patient is lying down with an eye mask on. There is time for quiet reflection," Zdyb said. "One of my patients said that under normal circumstances, without ketamine, she would be distracted by her own thoughts in response to what I would be saying to her. But within half an hour of taking the ketamine, that wasn't happening.
"She was able to be present to what I was saying and was able to get so much more out of the session because she wasn't distracted by that internal response to what I was saying to her."
The only other such therapy clinic in Ontario is in Toronto.