Some turn to ketamine as alternative treatment for mental health
Ketamine North Infusion Center in Duluth has administered about 5,000 infusions of ketamine since it opened in 2019. There are six clinics in Minnesota dedicated to ketamine infusions; North Dakota has two ketamine clinics in Fargo.
DULUTH — Patrick Bailey and Natalie Johnson knew there were clients in need when they opened the Ketamine North Infusion Center in Duluth in September 2019. The only doctor in the region who provided infusions had retired the year before and was concerned about what would happen to his patients.
Bailey and Johnson inherited those patients and have acquired many more over the last two-and-a-half years. The clinic has now provided about 5,000 infusions to clients as a treatment for depression, anxiety, post-traumatic stress disorder, bipolar depression, obsessive-compulsive disorder, substance use disorders and suicidal ideation.
Ketamine, a dissociative anesthetic, has been used in clinical settings for sedation since 1970 on humans and animals. Depending on its dosage, it can act as a hallucinogen and is used as a recreational drug, commonly known as Special K. A self-administered nasal spray, esketamine, was approved by the Food and Drug Administration in 2019 as an antidepressant.
“It’s all about dose and setting," Johnson said. "So if you get ketamine in a rave party, what happens to you is going to be a lot different than if you’re in a recliner with a weighted blanket and a mask listening to peaceful, healing music.”
That's the setup at Ketamine North. Each patient, who must receive a referral from a physician or psychiatrist to receive an infusion, sits in dark room that resembles a spa or massage parlor room in a reclining lounge chair with an eye mask, headphones and a blanket. The infusions are given six times over a two-week period to start. The goal is to feel a change in mindset and mood after the first six sessions, then space out infusions to occasional booster doses every month, slowly weaning off. The 40-minute IV infusion invokes different feelings in each patient, sometimes causing hallucinations.
For client Cassandra Bachtell, 48, an infusion feels like an indescribable, pleasant dream, but the experience isn't hallucinogenic for her.
“It’s kind of life free-floating outside of time and consciousness," Bachtell said. "You don’t really realize who you are and what you are. You just are.”
She sought ketamine treatment to help her heal from a traumatic childhood that had left her mind "shackled" through her life. After trying nearly every path she could find, including medications, therapy, and several spiritual healing journeys, the studies she read about ketamine compelled her to give it a try.
Before her ketamine treatment began at Ketamine North a year and a half ago, Bachtell said her mind was like a path in a forest that she knew led to nothing good, but she didn't know any other way. She was continuously repeating traumatic cycles because they were familiar to her. Now, she said she feels free. She's been able to remove negative situations from her life, and said her two children have noticed a positive change in her.
“All of a sudden the forest had hundreds of new paths," Bachtell said. "I had hundreds of new possibilities and instead of seeking out the familiar, I started to feel empowered to take new directions and head down new paths that were now available to me. That’s what ketamine did, and that, to me, was nothing short of miraculous.”
Bailey said some of the most powerful client transformations are those of patients with PTSD because they can relive their traumatic events and gain closure from addressing the source of their trauma.
“Ketamine is kind of like the bodyguard that goes to help you face the bullies," he said. "So you can go in there with a more empowered view, and once you’ve seen that view and it’s not scary to you anymore, it doesn’t terrorize you anymore.”
Ketamine North has had several pediatric patients age 12 and older, which Johnson said has been slightly controversial, but the young patients have had some of the most successful reactions to ketamine that they've seen.
Johnson said that although ketamine can be known as a "miracle drug" for its ability to reconnect neural pathways and stop suicidal thoughts after just one treatment, ketamine infusions alone likely won't cure someone.
“This is a tool, not a cure," she said. "We like to say 25% therapy, 25% ketamine, 50% you. So what are you doing when you’re not getting your ketamine?”
They work with patients before and after their infusions to help them set healthy lifestyle changes — some as simple as leaving their home and taking a walk around the block. Johnson is in her final semester of school to become a psychiatric nurse practitioner, so Ketamine North will soon have a mental health practitioner on staff.
Ketamine is approved by the FDA as an anesthetic agent and in the nasal spray form to treat depression. However, ketamine infusions have been the subject of many research studies for depression treatment. A study of ketamine as a therapy for treatment-resistant depression, published in 2017, showed the patient's Beck Depression index score was reduced by 50% after five IV ketamine treatments.
Some side effects of ketamine infusions include high blood pressure and heart rates, nausea, loss of bladder control and the feeling of a hangover during the first week of treatment. At Ketamine North, patients wear a heart rate monitor on their finger and have a baby monitor in the room so they are able to communicate with Johnson and Bailey at all times.
Johnson and Bailey are both licensed nurse anesthetists who previously worked in intensive care units. They administered ketamine regularly as an anesthetic, and were interested in harnessing its antidepressant capabilities in a region where ketamine was otherwise unavailable as a treatment option.
“It’s the most gratifying thing we’ve ever done," Bailey said. "We see people come in that have tried everything. When they first come in versus the sixth infusion, you can see the difference in their face; you can see the difference in their mannerisms.”
There are six clinics in Minnesota dedicated to ketamine infusions: Ketamine North in Duluth and five in the Twin Cities metro area. North Dakota has two ketamine clinics in Fargo. Johnson said when the clinic first opened, not everyone was aware that ketamine could be used as a mental health treatment option.
“Duluth is way behind the times, and even Minnesota is way behind the times," Johnson said. "Opening this up up here, people were like, ‘What? What?”
Now, Johnson said the practice is more recognized thanks to word-of-mouth and awareness. Physicians and psychiatrists in the area have also been more open to ketamine as a treatment option than before as they send referrals to the infusion center. Ketamine North treats patients from all over the Northland region, across northern Wisconsin and Michigan's Upper Peninsula.
Because of the high volume of clients, Johnson and Bailey are planning to open a second Ketamine North Infusion Center in Hibbing, Minnesota, as soon as this summer.
“By healing others, you heal yourself," Johnson said. "It’s the most gratifying thing in the world, knowing that you can truly go home and say you’ve made a difference.”