A ‘game changer’: Reno doctors see ketamine a solution for mental illnesses
December 18, 2017
Ketamine was first used in the 1960s as an anesthetic for wounded soldiers on the Vietnam battlefields.
Research on the drug progressed, and it has been found to be a viable treatment for pain management and, more important, mental health disorders including post-traumatic stress disorder, anxiety and severe depression.
Now, two Reno physicians, Bret Frey and Robert Watson, are making ketamine treatments available for the first time locally with the introduction of their new practice, Sierra Ketamine Clinics, at 15 McCabe Drive in south Reno.
Time magazine in August reported that an estimated 300 million people worldwide suffer from depression, and one-third of them don't find relief from antidepressants or other treatment options, leading to problems such as alcohol abuse, drug dependency and suicide.
"Ketamine is a real game changer," Watson said. "This kind of treatment can work as a leverage point to get people back to where they want to be in their lives."
The doctors contend that ketamine may be a solution for people with severe mental disorders and an alternative to antidepressants. In a segment aired on NBC Nightly News and posted on Sierra Ketamine Clinics' website, the drug reduced suicidal thoughts in 50 percent of patients immediately after treatment while antidepressant drugs can take weeks.
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"Ketamine can turn around mood disorders in a matter of hours even in a large percentage of folks who are suicidal," Frey said.
Frey pointed to one patient he treated recently, a teenager from Great Britain who was on the brink of suicide. Within hours, the teen was symptom-free.
"It was so gratifying to send the young man who was acutely suicidal within a short period of time on a commercial aircraft flying home with his mother," Frey said.
To qualify for treatment at Sierra Ketamine Clinics, a patient must first consult with either of the doctors, answering a series of questions. Prospective patients can apply for a consultation through the clinic's website or through a referral from a primary care physician.
If they qualify for the treatment, the doctors start by performing four 40-minute intravenous infusions of ketamine administered over a two-week span.
Some patients can be treated in as little as four to eight weeks before recovery, although other cases may take three to six months.
"We use very small doses, about one-fifth of what you would use to sedate a child," Watson said.
The doctors said ketamine works to regulate and maintain glutamate receptor activity, the most prominent neurotransmitter in the human body.
"Folks who have mood disorders such as depression, they have deficient levels of glutamate in their brain," Frey said.
The small doses aim to curb side effects while increasing receptor activity in the brain, thereby minimizing many disorders such as depression.
Because they are dealing with people with some form of mental health problems, the staff tries to relieve as much stress as possible for each patient. For instance, the clinic makes sure appointments are spaced so there is virtually no waiting period for patients once they arrive at the clinic.
There are four rooms where IV treatments are done, and each is designed to create a quiet and calm atmosphere. Tranquil music is provided if needed.
Frey and Watson were classmates at the University of Nevada, Reno School of Medicine in the early 1990s. After ketamine started to take off as a treatment for mental disorders, Frey became intrigued by the concept and researched ketamine treatment for seven years. He is now a regional expert on the topic.
"Being good friends, we talked about this for a while," Frey said of Watson. "We feel there is a dire need for this type of clinic in the region."
Watson, who also practices as a general surgeon, already had a medical office on McCabe Drive and it was a logical choice to house Sierra Ketamine Clinics there. He said the name of the business, which opened in early September, is pluralized in hopes that they will open more clinics in the future.
The clinic employs six part-time nurses, a medical assistant and a director of operations.
Operating the clinic hasn't always been smooth, though.
Frey said Hurricane Maria's devastation of Puerto Rico in late September created a challenge for the clinic because the island territory was a supplier of bags of saline used in the ketamine treatments. But they were able to secure an alternate supplier on the East Coast.
The federal Food and Drug Administration has yet to approve ketamine as a treatment for pain and mood disorders. In addition, there are questions from the medical profession regarding ketamine, which is also a recreational drug, and its effectiveness or its potential for health complications.
Ketamine treatments are not covered by insurance companies as of yet, Watson said, although it might be an expense that could be covered in a health savings account.
Still, Frey and Watson anticipate ketamine will be approved by the FDA as a treatment for mental health disorders and could be brought to market as a prescription drug within the next decade, likely forcing the clinic to adapt in some form.
In the meantime, Frey and Watson want to educate Northern Nevada about ketamine treatments for mental disorders, especially with so much attention being paid to the need for mental health treatment nationwide. The doctors are now creating a marketing strategy.
There are approximately 50 other ketamine treatment clinics nationwide, but only a handful in the West, including Boise, Denver, Las Vegas and Los Angeles.
"It is a fantastic product coming into the market at the right time for this community," Frey said.