Identifying Patients Who Could Benefit From Ketamine-Assisted Therapy

Andrea Turnipseed, LCSW, and Brent Turnipseed, MD, co-founders of Roots Behavioral Health, discuss the types of patients who do best with ketamine-assisted therapy, as well as what a clinician should look for in a potential referral source offering ketamine services if the clinician has a patient who they feel might be a fit.

Read the transcript:

Doug Edwards:  Hello. I'm Doug Edwards, Director of the Psychiatry and Behavioral Health Learning Network. Today, I'm joined by Dr. Brent and Andrea Turnipseed, Co-Founders of Roots Behavioral Health, which is an Austin-based organization offering innovative and holistic mental healthcare.

Dr. Turnipseed and Andrea are presenters at this year's Sana Symposium, and today, we will be discussing ketamine treatment models. Welcome, Dr. Turnipseed and Andrea. I'm so delighted you could join us this morning.

Dr. Brent Turnipseed:  Thank you, Douglas.

Andrea Turnipseed:  Thank you for having us.

Doug:  You're welcome. Dr. Turnipseed, I'm going to begin with you. As interest in psychedelics grows, frankly, so does interest in ketamine. What type of patients do best with this therapeutic option?

Dr. Turnipseed:  Thanks. Good question. If we look at the bulk of the evidence that's been accumulating using ketamine in treating mental health conditions for the past 20 years, the evidence is most robust in treating depression.

When I say depression, I mean major depressive disorder, bipolar depression. That even includes treatment-resistant depression, which is exciting because there's been a huge unmet need in treating depression for a long time.

If we look beyond depression, there's some recent exciting research that's come out of Mount Sinai in New York. Clinicians there have found that a handful of ketamine infusions might be especially effective in treating PTSD and trauma. That's exciting.

Looking beyond depression and PTSD, there's also been some exciting studies out of Columbia University in the past four or five years showing that ketamine leveraged with psychotherapy may be effective in treating alcohol use disorder and cocaine use disorder.

All these conditions together are things that are typically very difficult to treat in our field, so very exciting stuff.

Doug:  There's definitely a lot of growing interest about ketamine. I know many providers are either looking to offer it themselves or make referrals. Andrea, there, obviously, is growing interest in ketamine. There's, frankly, more ketamine providers opening.

What should a clinician look for in a potential referral source offering ketamine services if the clinician feels they have a patient who might be a fit?

Andrea:  If a clinician feels that they have a fit for ketamine services, I would look for an established clinic in the community and if there was any information from colleagues that it was well run and, most importantly, that they're working with other therapists.

If they have therapists on staff, that would be ideal, if not, at the very least, that they're working with therapists in the community to collaborate and coordinate care or allow therapists to come in and join the patient when they're doing a ketamine infusion or injection.

Doug:  It's about getting to know different providers in your region clearly and learning what kind of therapy they provide.

Andrea:  Yes. Obviously, any referrals from friends or family that it has worked well with, I would go with that, just as like when people find a psychiatrist. It's very personalized and unique. Not every clinic is going to be for every person and every style. In my opinion, having a therapist enhances the treatment.

Doug:  Moving on to the patient, Dr. Turnipseed, we live in an era where anyone can get medical information online, which it certainly have some pluses but definitely has some disadvantages as well.

What do you find are some of the best ways to educate patients who might benefit from ketamine, more than just suggesting they do a Google search, for example?

Dr. Turnipseed:  Also a good question. Misinformation abounds online. It's important to find the right resource. I usually steer people towards a low-tech resource, initially, which is two books, the first of which is called "Ketamine for Depression."

It came out about 2015, 2016. It was written by Stephen Hyde, who's a psychiatrist in Tasmania, and it's written in a language that is easy to understand for the general public and clinicians. In fact, I recommend it to patients.

I even recommend it to clinicians who are interested in learning more about referring to patients for ketamine treatment, or for clinicians who might be interested in working with ketamine themselves. I even get the book for our new clinicians at Roots that we onboard to give them a good broad background on ketamine and the history of the treatment.

Another book that's a great resource, a little bit more of a deep dive on ketamine, is called "The Ketamine Papers," which was edited and partly written by Phil Wolfson, who's a very important early pioneer in our field. Phil's a great psychiatrist out in the Bay Area.

The Ketamine Papers and Ketamine for Depression are great places to start. If people want to look online, I'd probably steer them towards The American Society of Ketamine Physicians, Psychotherapists, and Practitioners, or it's also called ASKP3.

That's an organization of providers, but they put on great conferences, where people exchange and share new ideas in our field. Patients, the general public can attend them. They put on webinars as well for the general public at times and clinicians. That's a great resource online as well as those two books.

Doug:  Andrea, anything you'd like to add on that topic?

Andrea:  Those are all great resources. I'd also say MAPS is another great organization that has put out some resources as well as conferences that we spoke at in 2019. They have YouTube videos in regards to our conference and other organizations, and links to places that are doing ketamine.

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Doug:  Thank you, Andrea and Dr. Turnipseed. I'd like to thank you for spending your time with us today.

Ladies and gentlemen, I hope you can join us to learn more about the latest in psychedelic research and treatment strategies for mental health and addiction professionals at the inaugural Sana symposium, which is a virtual event taking place this September from the same team that brings you Psych Congress, The Evolution of Psychotherapy, and the National Conference on Addiction Disorders.

To learn more or to register, visit sanasymposium.com