1 00:00:00,280 --> 00:00:02,080 Speaker 1: Coming up on you need therapy. 2 00:00:02,840 --> 00:00:06,080 Speaker 2: I've got a gentleman that when he came to me, 3 00:00:06,440 --> 00:00:11,119 Speaker 2: he tried several medicines, and his PHQ nine, which is 4 00:00:11,160 --> 00:00:15,440 Speaker 2: the Patient Health Questionnaire depression screening that we use, he 5 00:00:15,480 --> 00:00:18,720 Speaker 2: was scoring twenty seven out of twenty seven. So he 6 00:00:18,880 --> 00:00:21,720 Speaker 2: was one of the most severely depressed people that I've 7 00:00:21,760 --> 00:00:25,760 Speaker 2: ever seen. So I said, okay, let's try this. That 8 00:00:26,000 --> 00:00:29,720 Speaker 2: was probably two years ago. Today he boosters once a 9 00:00:29,760 --> 00:00:33,720 Speaker 2: month and his PHQ nine is four out of twenty seven, 10 00:00:34,360 --> 00:00:37,000 Speaker 2: which indicates no depression or mild depression. 11 00:00:38,200 --> 00:00:41,400 Speaker 3: I started to realize that not being an expert isn't 12 00:00:41,440 --> 00:00:43,560 Speaker 3: a liability, it's a real gift. 13 00:00:44,120 --> 00:00:46,800 Speaker 4: If we don't know something about ourselves at this point 14 00:00:46,800 --> 00:00:49,479 Speaker 4: in our life, it's probably because it's uncomfortable to know. 15 00:00:50,200 --> 00:00:53,080 Speaker 4: If you can die before you die, then you can 16 00:00:53,120 --> 00:00:56,560 Speaker 4: really live. There's a wisdom at death's door. 17 00:00:57,280 --> 00:01:00,440 Speaker 5: I thought it was insane. Yeah, I know what to 18 00:01:00,480 --> 00:01:01,639 Speaker 5: do because there's no Internet. 19 00:01:02,160 --> 00:01:05,360 Speaker 3: I don't know, man, I'm like, I feel like everything 20 00:01:06,240 --> 00:01:07,000 Speaker 3: is hard. 21 00:01:08,680 --> 00:01:10,120 Speaker 1: Hey, y'all, my name is Kat. 22 00:01:10,480 --> 00:01:13,640 Speaker 3: I'm a human first and a licensed therapist second, and 23 00:01:13,760 --> 00:01:16,960 Speaker 3: right now I'm inviting you into conversations that I hope 24 00:01:17,080 --> 00:01:22,520 Speaker 3: encourage you to become more curious and less judgmental about yourself, others, 25 00:01:22,640 --> 00:01:23,520 Speaker 3: and the world around you. 26 00:01:24,200 --> 00:01:26,640 Speaker 1: Welcome to You Need Therapy. 27 00:01:27,920 --> 00:01:30,720 Speaker 3: Hi guys, and welcome to a new episode of You 28 00:01:30,760 --> 00:01:34,560 Speaker 3: Need Therapy podcast. My name is kat I am the host, 29 00:01:34,760 --> 00:01:38,280 Speaker 3: and quick reminder before we get into everything today that 30 00:01:38,640 --> 00:01:41,320 Speaker 3: this podcast does not serve as a replacement or a 31 00:01:41,480 --> 00:01:45,920 Speaker 3: substitute for any actual mental health services, and it also 32 00:01:46,240 --> 00:01:49,920 Speaker 3: does not serve as any form of actual medical advice. 33 00:01:50,040 --> 00:01:54,960 Speaker 3: And that is especially important for me to say today 34 00:01:55,080 --> 00:01:59,040 Speaker 3: because today I have two people that I actually met 35 00:01:59,200 --> 00:02:01,440 Speaker 3: when I started working in a treatment center as an 36 00:02:01,440 --> 00:02:05,480 Speaker 3: intern and now actually refer a lot of my clients to. 37 00:02:05,680 --> 00:02:08,760 Speaker 3: Their names are Selena and Ronda. And Selena is a 38 00:02:08,800 --> 00:02:13,200 Speaker 3: Board certified family nurse practitioner that specializes in mental health, 39 00:02:13,919 --> 00:02:20,240 Speaker 3: and Ronda is a Board certified psychiatric mental health nurse practitioner, 40 00:02:21,040 --> 00:02:24,120 Speaker 3: and both of them have been really helpful to me 41 00:02:24,360 --> 00:02:28,359 Speaker 3: personally and with clients. And I asked them to come 42 00:02:28,480 --> 00:02:32,600 Speaker 3: talk today on the podcast because there is this thing 43 00:02:32,840 --> 00:02:36,360 Speaker 3: that is becoming more and more prominent. You might not 44 00:02:36,400 --> 00:02:37,720 Speaker 3: have heard of it. You might have heard of it, 45 00:02:37,720 --> 00:02:40,120 Speaker 3: you might have kind of caught a glimpse of somebody 46 00:02:40,160 --> 00:02:44,919 Speaker 3: talking about it, and that is using ketamine as treatment 47 00:02:45,080 --> 00:02:49,960 Speaker 3: for treatment resistant depression. So this is one of those things. 48 00:02:49,960 --> 00:02:52,160 Speaker 3: When I first heard it, I was like, whoa, whoa, whoa, 49 00:02:52,240 --> 00:02:55,320 Speaker 3: Like stop signing, there's no way that we're doing this. 50 00:02:55,320 --> 00:02:58,000 Speaker 3: This seems wrong. However, the more I learned and the 51 00:02:58,000 --> 00:03:01,440 Speaker 3: more I actually listened to some of the research, some 52 00:03:01,520 --> 00:03:05,040 Speaker 3: of what Rond and Selena were saying, and some of 53 00:03:05,160 --> 00:03:07,799 Speaker 3: just like the conversations around this, the more open I 54 00:03:07,919 --> 00:03:11,200 Speaker 3: became to this idea. So I asked them to come 55 00:03:11,240 --> 00:03:13,240 Speaker 3: talk about it, because it's one of those things where 56 00:03:13,240 --> 00:03:15,480 Speaker 3: it can be you know, put up the red flag 57 00:03:15,520 --> 00:03:17,760 Speaker 3: like I did at first, or it can be actually 58 00:03:17,800 --> 00:03:20,960 Speaker 3: really helpful to certain people. And I think it is 59 00:03:21,040 --> 00:03:23,880 Speaker 3: personally my job to stay up to date and educate 60 00:03:23,880 --> 00:03:27,200 Speaker 3: it and continue to listen to what new stuff is 61 00:03:27,240 --> 00:03:29,920 Speaker 3: coming out that we might want to let our clients 62 00:03:29,919 --> 00:03:31,400 Speaker 3: know about or just be aware of. 63 00:03:32,120 --> 00:03:33,880 Speaker 1: And so I wanted to have that. 64 00:03:33,880 --> 00:03:38,480 Speaker 3: Conversation today to maybe just give some information to you 65 00:03:38,560 --> 00:03:41,160 Speaker 3: guys who might not have ever heard about this being 66 00:03:41,280 --> 00:03:45,080 Speaker 3: used for depression and treatment, and some people that might 67 00:03:45,120 --> 00:03:47,880 Speaker 3: be interested in it, and some people who might be like, yeah, 68 00:03:47,880 --> 00:03:50,480 Speaker 3: that's not for me. We're just going to give you 69 00:03:50,520 --> 00:03:54,040 Speaker 3: some education, some information, so then you can actually decide 70 00:03:54,160 --> 00:03:57,040 Speaker 3: is this something that you would be open to, whether 71 00:03:57,080 --> 00:04:00,000 Speaker 3: or not it's you're somebody who has experienced treatment, resists 72 00:04:00,080 --> 00:04:02,920 Speaker 3: and depression, or maybe you're somebody who works with people 73 00:04:03,000 --> 00:04:06,360 Speaker 3: who have. So that's what we did today. We just 74 00:04:06,400 --> 00:04:09,120 Speaker 3: had a conversation. I asked some pretty basic questions. We 75 00:04:09,160 --> 00:04:12,200 Speaker 3: didn't get into too deep of the nitty gritty that 76 00:04:12,280 --> 00:04:14,000 Speaker 3: kind of like loses us when we're like, what actually 77 00:04:14,040 --> 00:04:16,160 Speaker 3: are we talking about. We just talked about the basics 78 00:04:16,200 --> 00:04:18,840 Speaker 3: of what this is, why people are using it, and 79 00:04:19,200 --> 00:04:21,360 Speaker 3: where it came from, why we even started using it. 80 00:04:21,880 --> 00:04:24,719 Speaker 3: So thank you very much to Ronda and Sulina for 81 00:04:24,760 --> 00:04:28,000 Speaker 3: having this conversation and for being people who have been 82 00:04:28,040 --> 00:04:31,320 Speaker 3: open to new advances in mental health treatment. 83 00:04:32,040 --> 00:04:32,280 Speaker 1: Now. 84 00:04:32,400 --> 00:04:35,719 Speaker 3: Ronda and Sulina both are the owners of the Willows 85 00:04:35,800 --> 00:04:39,960 Speaker 3: Health and Recovery which is located in Nashville, Tennessee. It's 86 00:04:39,960 --> 00:04:42,280 Speaker 3: actually very close to my office, so if you are 87 00:04:42,320 --> 00:04:44,200 Speaker 3: wanting to know more about them or want to learn 88 00:04:44,200 --> 00:04:46,680 Speaker 3: more about this, you can find them there Willow's Health 89 00:04:46,760 --> 00:04:49,599 Speaker 3: and Recovery dot Com. I will put that also in 90 00:04:49,640 --> 00:04:53,000 Speaker 3: the show notes. So I think it's about that time. 91 00:04:53,160 --> 00:04:58,800 Speaker 3: Let's get into my conversation with Selena and Ronda. Okay, guys, 92 00:04:58,920 --> 00:05:03,240 Speaker 3: I am here with two past colleagues, Ronda and Selena, 93 00:05:03,279 --> 00:05:08,560 Speaker 3: who I met probably in twenty thirteen, and we are 94 00:05:08,600 --> 00:05:11,720 Speaker 3: going to be talking about something that is somewhat sensitive, 95 00:05:12,080 --> 00:05:14,839 Speaker 3: might be a little well, it might be new for 96 00:05:14,880 --> 00:05:16,960 Speaker 3: a lot of you, and something that I've wanted to 97 00:05:17,000 --> 00:05:20,680 Speaker 3: talk about for a while, just myself professionally to learn 98 00:05:20,720 --> 00:05:23,040 Speaker 3: more about it, but also on the podcast to just 99 00:05:23,200 --> 00:05:26,200 Speaker 3: bring up some awareness and have a conversation about something 100 00:05:26,240 --> 00:05:30,160 Speaker 3: that might be controversial for some. And before we do that, 101 00:05:30,640 --> 00:05:33,560 Speaker 3: I want you guys to hear a little bit about 102 00:05:34,040 --> 00:05:37,880 Speaker 3: where Ronda and Selena come from, what has brought them 103 00:05:37,960 --> 00:05:41,239 Speaker 3: to what they are doing now, and why you should 104 00:05:41,320 --> 00:05:45,200 Speaker 3: even care about anything they say. So who wants to start? 105 00:05:45,600 --> 00:05:45,960 Speaker 1: Ronda? 106 00:05:46,560 --> 00:05:51,640 Speaker 4: I graduated from Vanderbilt in twenty thirteen, and I had 107 00:05:51,680 --> 00:05:55,280 Speaker 4: spent a year working at a residential treatment center here 108 00:05:55,320 --> 00:05:59,279 Speaker 4: in Tennessee as an intern, and then I was offered 109 00:05:59,279 --> 00:06:04,800 Speaker 4: a position. So basically, my first love from a clinical standpoint, 110 00:06:04,880 --> 00:06:08,520 Speaker 4: has always been working with those suffering from addiction. So 111 00:06:08,760 --> 00:06:12,120 Speaker 4: now been in the field for ten years and still 112 00:06:12,160 --> 00:06:15,560 Speaker 4: board certified as a psychiatric mental health nurse practitioner. And 113 00:06:16,400 --> 00:06:18,800 Speaker 4: I met Selena at that same residential treatment center where 114 00:06:18,800 --> 00:06:19,240 Speaker 4: we met you. 115 00:06:20,040 --> 00:06:23,240 Speaker 3: And I should say this now if you guys didn't 116 00:06:23,279 --> 00:06:26,040 Speaker 3: catch it in the intro, that RNDA and Selena actually 117 00:06:26,080 --> 00:06:29,600 Speaker 3: worked together. Now, so you guys met there and became 118 00:06:30,080 --> 00:06:32,480 Speaker 3: friends enough to the point where you want to keep 119 00:06:32,520 --> 00:06:36,080 Speaker 3: working together outside, and now they have their own would 120 00:06:36,120 --> 00:06:39,599 Speaker 3: you close a practice? Yes? Okay, practice very close to 121 00:06:39,640 --> 00:06:44,600 Speaker 3: where my office is in Nashville. So Selena, tell us where. 122 00:06:44,839 --> 00:06:45,600 Speaker 5: You came from. 123 00:06:45,839 --> 00:06:48,960 Speaker 2: I came from South Mississippi. So I actually started working 124 00:06:49,000 --> 00:06:52,000 Speaker 2: in mental health at age eighteen as a tech at 125 00:06:52,000 --> 00:06:55,080 Speaker 2: a psychiatric hospital and worked my way. I went to 126 00:06:55,160 --> 00:07:00,000 Speaker 2: nursing school, became a nurse, and then in twenty fourteen, 127 00:07:00,040 --> 00:07:04,360 Speaker 2: became a nurse practitioner. So I've been working in and 128 00:07:04,400 --> 00:07:07,559 Speaker 2: out of mental health and addiction since I was eighteen 129 00:07:07,600 --> 00:07:08,040 Speaker 2: years old. 130 00:07:08,560 --> 00:07:11,720 Speaker 3: What made you want to work at eighteen in the 131 00:07:11,800 --> 00:07:13,000 Speaker 3: psychiatric hospital. 132 00:07:13,240 --> 00:07:16,800 Speaker 2: The truth is that my aunt worked in human resources 133 00:07:16,920 --> 00:07:19,680 Speaker 2: at a hospital, and my mother told my aunt to 134 00:07:19,720 --> 00:07:20,480 Speaker 2: find me a job. 135 00:07:22,880 --> 00:07:27,360 Speaker 3: So was that a fun experience? So it was, and 136 00:07:27,440 --> 00:07:31,160 Speaker 3: it also really a weird word to say, but exciting, 137 00:07:31,480 --> 00:07:33,520 Speaker 3: sometimes hard, challenging. 138 00:07:33,360 --> 00:07:34,120 Speaker 5: Yes, it was. 139 00:07:34,320 --> 00:07:38,920 Speaker 2: And actually I helped open an adolescent child unit, so 140 00:07:39,040 --> 00:07:41,080 Speaker 2: right after I started working there, I worked there about 141 00:07:41,080 --> 00:07:44,040 Speaker 2: a year and then helped open that unit, and then 142 00:07:44,120 --> 00:07:46,760 Speaker 2: later became the nurse manager of that unit after I 143 00:07:46,960 --> 00:07:47,720 Speaker 2: became a nurse. 144 00:07:47,920 --> 00:07:49,360 Speaker 1: And it was one of. 145 00:07:49,360 --> 00:07:53,120 Speaker 2: Those things that I guess was led me to where 146 00:07:53,120 --> 00:07:55,840 Speaker 2: I am today. It made me look at myself and 147 00:07:55,880 --> 00:07:59,960 Speaker 2: look at my issues and my past trauma that had 148 00:08:00,000 --> 00:08:04,400 Speaker 2: i'd always just been squashed, you know, So it really 149 00:08:04,440 --> 00:08:06,880 Speaker 2: gave me a glimpse that people can heal. 150 00:08:07,160 --> 00:08:09,640 Speaker 3: It makes you look at I don't know how to 151 00:08:09,680 --> 00:08:12,960 Speaker 3: say this in the right way, but I think working 152 00:08:13,040 --> 00:08:17,000 Speaker 3: in a space like a psychiatric hospital or a residential 153 00:08:17,040 --> 00:08:21,960 Speaker 3: treatment center, we're seeing things that are in the world 154 00:08:22,000 --> 00:08:27,760 Speaker 3: out there looked at as bad or like evil or 155 00:08:27,840 --> 00:08:31,120 Speaker 3: I mean any of those just like icky stigma thoughts. 156 00:08:31,560 --> 00:08:33,040 Speaker 3: Then you get to work and one of those places 157 00:08:33,040 --> 00:08:35,600 Speaker 3: and you then you're like, wait, these are people and 158 00:08:36,200 --> 00:08:40,280 Speaker 3: we actually can help them. And it almost might be 159 00:08:40,320 --> 00:08:42,880 Speaker 3: a weird word to use, but it almost is addicting 160 00:08:43,320 --> 00:08:46,400 Speaker 3: to get into this field because then you see how 161 00:08:46,440 --> 00:08:49,200 Speaker 3: much it's very hard and can be very taxing, but 162 00:08:49,240 --> 00:08:52,040 Speaker 3: then you see like, oh my gosh, there's so much 163 00:08:52,120 --> 00:08:55,920 Speaker 3: good that you want to be able to spread from 164 00:08:56,160 --> 00:08:58,680 Speaker 3: absolutely changing your own mindset. 165 00:08:59,160 --> 00:09:02,760 Speaker 1: So when you started, you had an internship. 166 00:09:02,960 --> 00:09:06,600 Speaker 5: This is also very similar human resources. 167 00:09:06,600 --> 00:09:11,360 Speaker 4: No, No, but I worked at Vanderbilt for twenty years 168 00:09:11,400 --> 00:09:16,360 Speaker 4: before I went to graduate school, and it was through 169 00:09:17,120 --> 00:09:21,679 Speaker 4: trials and tribulations in life that led me to say, 170 00:09:21,840 --> 00:09:23,600 Speaker 4: I want to help other people get out of the 171 00:09:23,600 --> 00:09:28,160 Speaker 4: way of themselves. And I enrolled in Vanderbilt, got accepted. 172 00:09:28,760 --> 00:09:31,160 Speaker 4: Probably Yeah, I'm like, yeah, it's just because I was 173 00:09:31,160 --> 00:09:37,560 Speaker 4: an employee, right, But they sent me to the ranch. 174 00:09:37,800 --> 00:09:41,560 Speaker 4: Oh as for my internship, and I didn't know about 175 00:09:41,559 --> 00:09:45,559 Speaker 4: the ranch. I didn't know anything about psychiatry or addiction 176 00:09:45,720 --> 00:09:50,040 Speaker 4: treatment or anything. Before I was I worked in critical care. 177 00:09:50,520 --> 00:09:54,560 Speaker 1: Okay, yeah, so big shift. Isn't that funny? How like 178 00:09:54,600 --> 00:09:56,480 Speaker 1: life just like does that for you? 179 00:09:57,240 --> 00:09:59,000 Speaker 5: Absolutely, it is a little. 180 00:09:58,800 --> 00:10:00,679 Speaker 3: Lesson on how we don don't need to be in 181 00:10:00,760 --> 00:10:01,760 Speaker 3: control so often. 182 00:10:01,960 --> 00:10:04,680 Speaker 5: No, And I tell my kids that all the time. 183 00:10:04,800 --> 00:10:08,320 Speaker 2: Yeah, at eighteen, I never would have solved that I 184 00:10:08,320 --> 00:10:09,560 Speaker 2: would be here. 185 00:10:09,720 --> 00:10:11,160 Speaker 5: Yeah, that was certainly not my plan. 186 00:10:11,480 --> 00:10:13,560 Speaker 3: Yeah, you know what. Actually, my plan when I went 187 00:10:13,600 --> 00:10:15,480 Speaker 3: to college was to be a nurse. And then I 188 00:10:15,480 --> 00:10:18,160 Speaker 3: got to college, I took one anatomy class and I said, 189 00:10:18,320 --> 00:10:20,560 Speaker 3: this is not for me, and I got. 190 00:10:20,400 --> 00:10:20,959 Speaker 1: Out of there. 191 00:10:22,160 --> 00:10:26,400 Speaker 3: Okay, so today what we are going to talk about, 192 00:10:26,960 --> 00:10:29,319 Speaker 3: and again, I want you guys to listen to this 193 00:10:29,400 --> 00:10:33,920 Speaker 3: episode as a step. This is like one step to 194 00:10:34,880 --> 00:10:39,240 Speaker 3: a whole world of information. So I want you to 195 00:10:39,280 --> 00:10:44,760 Speaker 3: take whatever you're hearing not as like gold and truth 196 00:10:44,840 --> 00:10:47,600 Speaker 3: and God's word. I want you to take this as 197 00:10:48,040 --> 00:10:51,080 Speaker 3: something that might help you become more curious and open 198 00:10:51,440 --> 00:10:56,040 Speaker 3: to a new type of treatment that I find very interesting, 199 00:10:56,080 --> 00:10:57,680 Speaker 3: and I honestly don't know that much about it. 200 00:10:57,720 --> 00:10:59,000 Speaker 1: So that's one of the reasons, like I said, I 201 00:10:59,040 --> 00:11:00,000 Speaker 1: want to have this conversation. 202 00:11:00,160 --> 00:11:04,440 Speaker 3: So we're talking about ketamine, which I will tell you 203 00:11:05,040 --> 00:11:07,040 Speaker 3: I have a little bit of information of how this 204 00:11:07,160 --> 00:11:09,280 Speaker 3: is not what I used to think it was. But 205 00:11:09,320 --> 00:11:11,320 Speaker 3: when I think of ketamine, I just think of like 206 00:11:11,960 --> 00:11:13,880 Speaker 3: really intense street drug. 207 00:11:14,320 --> 00:11:17,000 Speaker 1: What is it special? Okay, Okay, it sounds scary to me. 208 00:11:17,800 --> 00:11:22,679 Speaker 3: So I want you guys to in the simplest way 209 00:11:22,720 --> 00:11:26,240 Speaker 3: you can explain, Okay, what is ketamine? How is it 210 00:11:26,280 --> 00:11:28,160 Speaker 3: more than just this drug that we might have heard 211 00:11:28,160 --> 00:11:38,040 Speaker 3: about in their class and fifth grade In the simplest 212 00:11:38,040 --> 00:11:41,640 Speaker 3: way you can explain, Okay, what is ketamine? How is 213 00:11:41,679 --> 00:11:43,440 Speaker 3: it more than just this drug that we might have 214 00:11:43,520 --> 00:11:45,720 Speaker 3: heard about in class and fifth grade. 215 00:11:46,080 --> 00:11:50,080 Speaker 4: Well, kenymine was first synthesized in the nineteen sixties and 216 00:11:50,160 --> 00:11:53,800 Speaker 4: it was used for humans and animals as an anesthetic, 217 00:11:54,280 --> 00:11:58,720 Speaker 4: and it's made it popular choice for surgical procedures because 218 00:11:58,760 --> 00:12:03,800 Speaker 4: it's so dissociated in nature that people can it's not 219 00:12:03,840 --> 00:12:07,000 Speaker 4: really a pain medicine, but they can tolerate, let's say, 220 00:12:07,000 --> 00:12:12,200 Speaker 4: alone bar puncture, or they can tolerate if they dislocated 221 00:12:12,240 --> 00:12:16,080 Speaker 4: their shoulder that being put back into place. And the doses, 222 00:12:16,280 --> 00:12:19,600 Speaker 4: of course for an anesthetic are way higher than they 223 00:12:19,600 --> 00:12:23,760 Speaker 4: are to treat depression. And it wasn't until really the 224 00:12:23,800 --> 00:12:29,959 Speaker 4: early two thousands when there were several psychiatrists, one being 225 00:12:30,360 --> 00:12:34,920 Speaker 4: doctor Ceven Levine from New Jersey Princeton, New Jersey, who 226 00:12:35,240 --> 00:12:39,080 Speaker 4: had evaluated a client and really went into great depth 227 00:12:39,120 --> 00:12:42,439 Speaker 4: in detail to find out and no medicine had ever 228 00:12:42,480 --> 00:12:45,680 Speaker 4: worked except for this one time when they were on 229 00:12:46,480 --> 00:12:51,520 Speaker 4: a certain cough medicine, so that got his brain really 230 00:12:51,559 --> 00:12:54,800 Speaker 4: looking like, oh my gosh, is this about a certain 231 00:12:54,800 --> 00:12:57,920 Speaker 4: receptor in the brain that that cough medicine was targeting, 232 00:12:58,920 --> 00:13:03,240 Speaker 4: and that he was really revolutionary and one of the 233 00:13:03,280 --> 00:13:08,559 Speaker 4: psychiatrists that started doing a lot of research and actually 234 00:13:09,120 --> 00:13:12,760 Speaker 4: established ketymine options there with. 235 00:13:12,760 --> 00:13:14,559 Speaker 1: The cough medicine that was there. 236 00:13:14,559 --> 00:13:16,960 Speaker 3: Wasn't ketymine and a cough medicine, they were just looking 237 00:13:17,040 --> 00:13:21,959 Speaker 3: at a receptor that both of those maybe active drugs attacked. 238 00:13:22,000 --> 00:13:24,680 Speaker 1: Okay, that's fascinating. 239 00:13:24,840 --> 00:13:29,560 Speaker 3: And what I want people to know when listening to this, 240 00:13:29,679 --> 00:13:35,240 Speaker 3: we're talking about ketamine as a treatment for depression, right. 241 00:13:35,240 --> 00:13:36,800 Speaker 5: Right, treatment resistant depression. 242 00:13:36,840 --> 00:13:40,199 Speaker 3: Okay, so what is treatment resistant depression? 243 00:13:40,360 --> 00:13:40,880 Speaker 1: How is that? 244 00:13:40,920 --> 00:13:42,920 Speaker 3: What does that mean compared to like, is that like 245 00:13:42,960 --> 00:13:46,280 Speaker 3: the diagnosis you give them, compared to major depressive disorder? 246 00:13:46,400 --> 00:13:47,959 Speaker 3: Is that just a type? What does that mean? 247 00:13:48,440 --> 00:13:52,760 Speaker 2: So typically people have a major depressive disorder diagnosis, but 248 00:13:52,840 --> 00:13:55,880 Speaker 2: when they come see us, they will do full psychiatric 249 00:13:55,960 --> 00:13:59,640 Speaker 2: evaluation and look at their medical history as well. But 250 00:14:00,280 --> 00:14:04,200 Speaker 2: as far as treatment resistant goes, really you only need 251 00:14:04,640 --> 00:14:10,559 Speaker 2: two of the traditional medication failures of the oral antidepressants, 252 00:14:10,600 --> 00:14:15,640 Speaker 2: and those are your typically your SSRIs SNRIs, like your 253 00:14:15,760 --> 00:14:19,080 Speaker 2: pro likes a pro well beuchure and effects ers, those 254 00:14:19,160 --> 00:14:21,240 Speaker 2: kind of things. So really you just need to fail 255 00:14:21,400 --> 00:14:25,400 Speaker 2: two of those type of medications to be considered treatment resistant. 256 00:14:26,200 --> 00:14:28,240 Speaker 1: That feels a little common. 257 00:14:29,000 --> 00:14:35,280 Speaker 3: Absolutely, absolutely do you find it frustrating for clients, Like, 258 00:14:35,320 --> 00:14:37,400 Speaker 3: what's your experience with a client who's coming to see 259 00:14:37,440 --> 00:14:39,680 Speaker 3: you for medication and medication management? 260 00:14:40,160 --> 00:14:41,720 Speaker 1: And I know. 261 00:14:41,760 --> 00:14:44,440 Speaker 3: From my little experience with some of that with my 262 00:14:44,520 --> 00:14:47,080 Speaker 3: clients that sometimes it takes a while to figure out 263 00:14:47,080 --> 00:14:51,440 Speaker 3: what's going to work. So how do you differentiate between 264 00:14:51,840 --> 00:14:53,200 Speaker 3: it's going to take a while for us to figure 265 00:14:53,200 --> 00:14:56,160 Speaker 3: out what's going to work in the dosage and when 266 00:14:56,240 --> 00:14:57,880 Speaker 3: like this just isn't working. 267 00:14:58,480 --> 00:15:00,440 Speaker 4: Many times, So a lot of the clients that come 268 00:15:00,480 --> 00:15:03,760 Speaker 4: to see us, they've got a list of mile long, 269 00:15:04,760 --> 00:15:09,160 Speaker 4: or they haven't had genetic testing, or you know, because oh, 270 00:15:09,200 --> 00:15:11,800 Speaker 4: my primary care physician has been managing it, and then 271 00:15:11,920 --> 00:15:14,600 Speaker 4: before that I saw I saw this person, I can't 272 00:15:14,640 --> 00:15:15,760 Speaker 4: remember their name, you know. 273 00:15:15,840 --> 00:15:18,040 Speaker 5: So usually by the. 274 00:15:18,000 --> 00:15:21,359 Speaker 4: Time they get to see us, you see like failures 275 00:15:21,360 --> 00:15:25,560 Speaker 4: with SSRIs or SNRIs and they haven't completed genetic testing, 276 00:15:25,600 --> 00:15:28,640 Speaker 4: which can help us learn how they metabolize medicines and 277 00:15:28,680 --> 00:15:29,360 Speaker 4: better medicines. 278 00:15:29,360 --> 00:15:30,000 Speaker 5: For their body. 279 00:15:30,280 --> 00:15:33,640 Speaker 3: Could you say more about that? Yeah, So what is 280 00:15:33,680 --> 00:15:37,040 Speaker 3: genetic testing in the form you're talking about. 281 00:15:37,200 --> 00:15:39,560 Speaker 4: It's the mouse swap and we can do it here 282 00:15:39,600 --> 00:15:41,560 Speaker 4: in the office. We can send it to their home 283 00:15:42,240 --> 00:15:44,640 Speaker 4: and they can complete it and then ship it back 284 00:15:44,680 --> 00:15:48,680 Speaker 4: and we learn several things. We learn most importantly for me, Selena, 285 00:15:48,680 --> 00:15:51,440 Speaker 4: and I don't know how you consider this, but for me, 286 00:15:51,640 --> 00:15:56,080 Speaker 4: it is how you metabolize medicines based on your genetics, 287 00:15:56,440 --> 00:16:01,440 Speaker 4: because you could be a rapid metabolizer of multiple say ssries, 288 00:16:02,200 --> 00:16:05,520 Speaker 4: So it's going to take a higher dose to reach 289 00:16:05,680 --> 00:16:09,640 Speaker 4: therapeutic effect. And so that's I think so helpful to 290 00:16:09,760 --> 00:16:13,520 Speaker 4: know that, and that's going to always be my first option. Like, 291 00:16:13,600 --> 00:16:18,560 Speaker 4: let's look at this, but if somebody is acutely depressed 292 00:16:19,280 --> 00:16:25,520 Speaker 4: and or suicidal, I might forego that and recommend kedemye. 293 00:16:25,880 --> 00:16:30,800 Speaker 3: Okay, so let's switch to what got you guys into 294 00:16:31,720 --> 00:16:33,880 Speaker 3: being interested in using this. 295 00:16:34,880 --> 00:16:37,640 Speaker 2: I think for me it was seeing so many people 296 00:16:38,000 --> 00:16:41,160 Speaker 2: just come to me and be kind of at the 297 00:16:41,280 --> 00:16:44,600 Speaker 2: end of their rope, meaning that they have tried so 298 00:16:44,680 --> 00:16:48,600 Speaker 2: many medications in the past and nothing work, or it 299 00:16:48,640 --> 00:16:50,760 Speaker 2: works for a little while and then it stops, and 300 00:16:50,800 --> 00:16:53,320 Speaker 2: then you know, before they know it, they're on three 301 00:16:53,320 --> 00:16:58,560 Speaker 2: and four medications and still just not feeling well. We 302 00:16:58,840 --> 00:17:02,640 Speaker 2: had seen it used at the residential treatment center that 303 00:17:02,640 --> 00:17:06,520 Speaker 2: we were at before and saw really good results. And 304 00:17:06,560 --> 00:17:10,560 Speaker 2: then I also have collaborated with another physician in town 305 00:17:10,640 --> 00:17:16,840 Speaker 2: that provides ketamine and have heard, you know, his stories 306 00:17:16,840 --> 00:17:20,840 Speaker 2: of success of how well people do with it, and 307 00:17:21,040 --> 00:17:24,280 Speaker 2: Spravado had came out, which we can talk about that, 308 00:17:24,960 --> 00:17:29,320 Speaker 2: and really we just wanted to find a way to 309 00:17:29,359 --> 00:17:30,920 Speaker 2: think outside of the box. 310 00:17:30,720 --> 00:17:35,920 Speaker 3: To better options here. Yes, do you remember your initial 311 00:17:35,960 --> 00:17:38,679 Speaker 3: thoughts when you first were introduced to it. 312 00:17:39,160 --> 00:17:41,560 Speaker 4: I couldn't believe our medical director was going to do it. 313 00:17:41,840 --> 00:17:43,200 Speaker 4: I'm like, oh my god. 314 00:17:43,560 --> 00:17:44,160 Speaker 1: I remember. 315 00:17:44,200 --> 00:17:46,359 Speaker 3: I think we were probably all there at the same time. 316 00:17:46,440 --> 00:17:49,240 Speaker 3: I remember when we were at the treatment center we 317 00:17:49,280 --> 00:17:51,119 Speaker 3: had this meeting. I'm pretty sure I was the intern 318 00:17:51,160 --> 00:17:54,760 Speaker 3: at the time. I went with my supervisor and she 319 00:17:55,000 --> 00:17:58,160 Speaker 3: was already like kind of I can't believe this is what. 320 00:17:58,080 --> 00:17:59,359 Speaker 1: Are we going to this meeting for? 321 00:18:00,200 --> 00:18:02,960 Speaker 3: And then I just remember I think I took on 322 00:18:03,600 --> 00:18:06,160 Speaker 3: her anger, yeah, because I didn't know what to think, 323 00:18:06,160 --> 00:18:08,600 Speaker 3: because I'm like teacher, you whatever, But there was a 324 00:18:08,680 --> 00:18:13,240 Speaker 3: sense of wait, what we're using this drug that people 325 00:18:13,760 --> 00:18:17,679 Speaker 3: abuse in the world out there, we're going to get 326 00:18:17,680 --> 00:18:20,120 Speaker 3: then give it to them for medicine, and I didn't 327 00:18:20,119 --> 00:18:22,840 Speaker 3: have an understanding of medicine and the fact that like 328 00:18:23,280 --> 00:18:27,080 Speaker 3: that sometimes it's actually very common. But I remember just 329 00:18:27,119 --> 00:18:32,960 Speaker 3: being shocked and also feeling very resistant and also wanting 330 00:18:33,080 --> 00:18:36,960 Speaker 3: to not like it felt like a secret, almost like 331 00:18:36,960 --> 00:18:39,000 Speaker 3: I don't want people to know I would be doing 332 00:18:39,040 --> 00:18:40,480 Speaker 3: this or encouraging this. 333 00:18:40,760 --> 00:18:42,399 Speaker 2: And I get that, and I think I felt a 334 00:18:42,400 --> 00:18:46,400 Speaker 2: lot of the same way when when we started using 335 00:18:46,440 --> 00:18:50,480 Speaker 2: it at the treatment center. However, since then we have 336 00:18:50,640 --> 00:18:56,120 Speaker 2: learned that after our own education, is that the dosing 337 00:18:56,240 --> 00:18:59,280 Speaker 2: that we use in our office for treatment resistant depression 338 00:18:59,800 --> 00:19:02,000 Speaker 2: is there's nothing like that I'm seeing that people are 339 00:19:02,040 --> 00:19:05,920 Speaker 2: taking on the street. Obviously it is under a controlled 340 00:19:05,960 --> 00:19:10,320 Speaker 2: setting here in our office, so there's really not an 341 00:19:10,320 --> 00:19:13,960 Speaker 2: abuse potential from that. By the time they leave our office, 342 00:19:13,960 --> 00:19:15,439 Speaker 2: the medicine has cleared their system. 343 00:19:15,800 --> 00:19:21,800 Speaker 3: When I think it's important to have our beliefs in 344 00:19:21,840 --> 00:19:24,879 Speaker 3: our understandings and we're all gonna have a little bias 345 00:19:24,920 --> 00:19:25,560 Speaker 3: in everything that we. 346 00:19:25,520 --> 00:19:27,639 Speaker 1: Do, but also remain open. 347 00:19:28,400 --> 00:19:31,720 Speaker 3: Because if I was as closed off as I was 348 00:19:31,760 --> 00:19:33,800 Speaker 3: when I was twenty three, and I was like, I'm 349 00:19:33,800 --> 00:19:34,280 Speaker 3: so smart. 350 00:19:34,960 --> 00:19:37,440 Speaker 1: It sounds like a lot of your clients would miss. 351 00:19:37,240 --> 00:19:40,200 Speaker 3: Out on an opportunity to actually find something that works 352 00:19:40,240 --> 00:19:49,200 Speaker 3: for them. Can you explain what this does? How does 353 00:19:49,240 --> 00:19:52,400 Speaker 3: this work? What's the process of people? You mentioned people 354 00:19:52,440 --> 00:19:54,880 Speaker 3: are in your office when they're doing this. It's it's 355 00:19:54,920 --> 00:19:57,000 Speaker 3: not something you get prescribed and you go take it 356 00:19:57,000 --> 00:19:57,400 Speaker 3: at home. 357 00:19:58,280 --> 00:20:01,000 Speaker 1: We do not do that. Yeah, a thing that happens. 358 00:20:01,560 --> 00:20:05,639 Speaker 2: It can be prescribed orally as a sublingual tablet or 359 00:20:05,920 --> 00:20:09,840 Speaker 2: a tablet that you swallow, but we don't offer that 360 00:20:09,920 --> 00:20:10,520 Speaker 2: in our office. 361 00:20:10,680 --> 00:20:15,120 Speaker 4: And it's not very effective. Oh because of the worl 362 00:20:15,280 --> 00:20:19,280 Speaker 4: route by. Availability of the drug is just not there. Okay, 363 00:20:19,359 --> 00:20:25,040 Speaker 4: So there's some clinics that are all on Facebook that 364 00:20:25,119 --> 00:20:27,639 Speaker 4: are I think I'm not going to mention it, but 365 00:20:28,240 --> 00:20:31,240 Speaker 4: that are offering this in home treatment with ketamine, and 366 00:20:31,280 --> 00:20:35,160 Speaker 4: I just would urge people to get Yeah. 367 00:20:35,480 --> 00:20:37,399 Speaker 2: And I actually had a client that tried it and 368 00:20:37,440 --> 00:20:39,840 Speaker 2: then she came back and she was like, that didn't 369 00:20:39,960 --> 00:20:40,680 Speaker 2: that didn't help. 370 00:20:40,840 --> 00:20:43,879 Speaker 3: And that can be a little bit disheartening and discouraging 371 00:20:43,960 --> 00:20:46,359 Speaker 3: too for somebody who's like this is my last effort. 372 00:20:46,520 --> 00:20:50,720 Speaker 1: Maybe sometimes what they feel. So can you talk about really. 373 00:20:50,400 --> 00:20:52,960 Speaker 3: What that is doing, Like what is that compared to 374 00:20:53,040 --> 00:20:55,160 Speaker 3: like an ssri ketamine. 375 00:20:55,280 --> 00:20:57,760 Speaker 4: You know, there's been a lot of research on well 376 00:20:57,760 --> 00:21:02,640 Speaker 4: how does this work and what they've really focused on 377 00:21:03,040 --> 00:21:09,360 Speaker 4: the NMDA receptor in the brain, and this the theory 378 00:21:09,520 --> 00:21:14,000 Speaker 4: because we don't know truly what causes depression. We don't know. 379 00:21:14,920 --> 00:21:18,760 Speaker 4: One theory is that due to inflammation, if there are 380 00:21:18,800 --> 00:21:22,360 Speaker 4: areas of the brain that are just kind of they're 381 00:21:22,400 --> 00:21:27,800 Speaker 4: not working anymore. So this ketamine comes in and really 382 00:21:27,840 --> 00:21:30,800 Speaker 4: targets that receptor and kind of opens those pathways back 383 00:21:30,880 --> 00:21:36,679 Speaker 4: up and really kind of creates more neural connections. And 384 00:21:36,760 --> 00:21:41,359 Speaker 4: neuroplasticity is a big word we're using these days, and 385 00:21:41,400 --> 00:21:45,560 Speaker 4: it can have a really rapid onset, whereas oral antidepressence 386 00:21:45,680 --> 00:21:49,440 Speaker 4: can take five six weeks to even show a slight 387 00:21:49,520 --> 00:21:52,800 Speaker 4: bit of efficacy. Some people may feel a little bit 388 00:21:52,840 --> 00:21:57,360 Speaker 4: better after the first treatment, usually by treatment for it's 389 00:21:57,480 --> 00:22:02,880 Speaker 4: pretty significant difference in and they're scoring of their depression. 390 00:22:02,520 --> 00:22:07,399 Speaker 3: Levels even after this drug is no longer in their system. Yeah, 391 00:22:07,720 --> 00:22:12,160 Speaker 3: so I'm going to repeat this back just to summarize, 392 00:22:12,240 --> 00:22:15,320 Speaker 3: make sure I'm hearing the correct thing. So this is 393 00:22:15,359 --> 00:22:21,040 Speaker 3: a drug that when it's active, it changes you say, neuroplasticity. 394 00:22:21,560 --> 00:22:24,760 Speaker 3: It actually changes and allows the brain to kind of 395 00:22:24,800 --> 00:22:29,840 Speaker 3: like rewire itself and open up long term and maintain 396 00:22:29,960 --> 00:22:34,520 Speaker 3: that versus another medication that might just be taken long 397 00:22:34,640 --> 00:22:38,680 Speaker 3: term is doing that kind of like every single time 398 00:22:38,800 --> 00:22:39,440 Speaker 3: you take it. 399 00:22:39,480 --> 00:22:40,320 Speaker 1: Does that make sense? 400 00:22:40,680 --> 00:22:42,840 Speaker 3: Yes, And I just think that's over and over to 401 00:22:42,880 --> 00:22:46,680 Speaker 3: get that same result versus this actually changes the chemistry 402 00:22:46,680 --> 00:22:48,240 Speaker 3: of your brain kind of. 403 00:22:48,920 --> 00:22:52,399 Speaker 2: I will say that the oral anidepressants are acting on 404 00:22:52,400 --> 00:22:56,800 Speaker 2: the neurotransmitters serotonin orpanifferent diepamine. This is acting on the 405 00:22:56,840 --> 00:22:59,560 Speaker 2: glutamate system of our brain. So actually then we get 406 00:23:00,040 --> 00:23:02,600 Speaker 2: we get communication between the two systems in our brain. 407 00:23:03,040 --> 00:23:06,000 Speaker 4: Okay, And on top of that, they've only really done 408 00:23:06,080 --> 00:23:10,920 Speaker 4: research on the NMDA receptor, but ketamine hits so many 409 00:23:10,960 --> 00:23:16,040 Speaker 4: more neurotransmitters. It hits opioid, the mute opioid receptor, the 410 00:23:16,080 --> 00:23:21,520 Speaker 4: serotonin nor ep from dopamine transporter, dopamine IWI transporter. You 411 00:23:21,520 --> 00:23:24,760 Speaker 4: think about a broad spectrum antibiotic that really goes in 412 00:23:24,960 --> 00:23:28,959 Speaker 4: and just we're gonna kill this infection. You know, this 413 00:23:29,080 --> 00:23:31,320 Speaker 4: to me is a broad spectrum antidepressant. 414 00:23:31,480 --> 00:23:33,960 Speaker 3: Versus targeting one thing, correct, right, but we only have 415 00:23:34,040 --> 00:23:35,480 Speaker 3: research on the one thing right now. 416 00:23:35,520 --> 00:23:37,480 Speaker 4: Well there's limited rears. 417 00:23:37,640 --> 00:23:43,960 Speaker 3: Yeah, okay, So Selena, you mentioned Spervado can you talk. 418 00:23:43,840 --> 00:23:44,560 Speaker 1: About what that is? 419 00:23:45,080 --> 00:23:45,399 Speaker 5: Sure? 420 00:23:45,600 --> 00:23:52,640 Speaker 2: Spervado is the FDA approved version of ketamine that chants 421 00:23:52,680 --> 00:23:56,760 Speaker 2: and pharmaceuticals came up with. They changed like one isomer 422 00:23:56,960 --> 00:24:01,280 Speaker 2: of ketamine to make esketamine under a trade name Spravado 423 00:24:02,000 --> 00:24:05,000 Speaker 2: and got it FDA approved for treatment resistant depression as 424 00:24:05,000 --> 00:24:09,760 Speaker 2: well as acute suicidal idiations. So with that, you have 425 00:24:09,840 --> 00:24:15,280 Speaker 2: to be a RAMS provider, which is a risk evaluation 426 00:24:15,480 --> 00:24:16,720 Speaker 2: and mitigation strategy. 427 00:24:16,960 --> 00:24:18,240 Speaker 1: Is that something you have to get. 428 00:24:18,960 --> 00:24:21,040 Speaker 2: You have to be approved okay for that, And we 429 00:24:21,119 --> 00:24:24,040 Speaker 2: did get approval for that, and we are a RAM 430 00:24:24,119 --> 00:24:26,520 Speaker 2: certified Spravado treatment center here. 431 00:24:27,240 --> 00:24:29,040 Speaker 5: And we offer it. 432 00:24:29,040 --> 00:24:33,359 Speaker 2: It's Spravado is a nasal spray and it's administered twice 433 00:24:33,400 --> 00:24:36,200 Speaker 2: weekly for four weeks and then once weekly for four 434 00:24:36,200 --> 00:24:38,200 Speaker 2: weeks and then booster as needed. 435 00:24:38,560 --> 00:24:41,560 Speaker 3: And they'll come into your office get that and then 436 00:24:41,680 --> 00:24:42,200 Speaker 3: stay here. 437 00:24:42,480 --> 00:24:44,080 Speaker 5: Yes, they're here for two hours. 438 00:24:43,800 --> 00:24:45,920 Speaker 1: Okay, and they're being monitored. 439 00:24:45,480 --> 00:24:48,040 Speaker 2: Yes, and are not allowed to drive home, so they'll 440 00:24:48,080 --> 00:24:50,399 Speaker 2: have to have a driver or a ride share. 441 00:24:50,680 --> 00:24:53,600 Speaker 3: Okay, what is the conversation like when you have a 442 00:24:53,640 --> 00:24:58,000 Speaker 3: client who comes in and maybe has tried a lot 443 00:24:58,040 --> 00:25:00,159 Speaker 3: of stuff already, so it's like you don't even have 444 00:25:00,200 --> 00:25:02,600 Speaker 3: to go through that and you see their intake form 445 00:25:02,640 --> 00:25:05,639 Speaker 3: and you see all their medication history. What's the conversation 446 00:25:05,800 --> 00:25:09,320 Speaker 3: like for you inviting them into trying this? 447 00:25:10,080 --> 00:25:10,320 Speaker 1: Well? 448 00:25:10,359 --> 00:25:13,359 Speaker 4: I think depending upon their you know, you're also going 449 00:25:13,359 --> 00:25:17,879 Speaker 4: to evaluate your medical history. Ketymine and Spravado can transiently 450 00:25:18,119 --> 00:25:23,439 Speaker 4: increase blood pressure, and so for spravado and ketymine. But 451 00:25:23,960 --> 00:25:27,240 Speaker 4: as you know, a certified rooms treatment center, if a 452 00:25:27,280 --> 00:25:31,359 Speaker 4: client has any aneurysmal disease so that's disease of the 453 00:25:31,440 --> 00:25:36,639 Speaker 4: vessels or hypertension that's not well controlled, that would be 454 00:25:36,640 --> 00:25:41,360 Speaker 4: a contraindication for treatment. So we take the whole client 455 00:25:41,640 --> 00:25:44,560 Speaker 4: and where they are, and you know, ask them what 456 00:25:44,600 --> 00:25:46,960 Speaker 4: their goals are because we're here to support them and 457 00:25:47,040 --> 00:25:48,720 Speaker 4: reaching what they want. 458 00:25:49,119 --> 00:25:52,240 Speaker 3: Do you get pushback from clients? Are you seeing pushback 459 00:25:52,280 --> 00:25:53,880 Speaker 3: of like, oh no, I don't want to do that, 460 00:25:54,640 --> 00:25:57,840 Speaker 3: or do you find that that it kind of offers 461 00:25:57,840 --> 00:25:59,640 Speaker 3: them some hope when they feel defeated. 462 00:26:00,400 --> 00:26:02,920 Speaker 2: I think it absolutely offers hope. I mean, I think 463 00:26:03,080 --> 00:26:07,600 Speaker 2: some people have a little reservation because they feel maybe 464 00:26:07,800 --> 00:26:11,560 Speaker 2: like it's a last ditch effort. 465 00:26:11,760 --> 00:26:13,720 Speaker 5: You know, it doesn't work, then what a way, right? 466 00:26:14,040 --> 00:26:17,960 Speaker 2: But I try to reframe that with them and say, 467 00:26:18,000 --> 00:26:20,560 Speaker 2: but this is something that we can have hope for. 468 00:26:20,800 --> 00:26:24,240 Speaker 2: I have seen it work in my office in my practice, 469 00:26:25,160 --> 00:26:27,720 Speaker 2: So just trying to reframe it to that. 470 00:26:27,880 --> 00:26:32,920 Speaker 4: Is seventy percent remission rates. That's what the data is 471 00:26:32,920 --> 00:26:35,919 Speaker 4: showing with spravado and with ketamine. 472 00:26:36,440 --> 00:26:38,119 Speaker 3: I mean, do we have research on what that is 473 00:26:38,119 --> 00:26:39,720 Speaker 3: compared to like prozac. 474 00:26:40,080 --> 00:26:45,919 Speaker 4: Well, if prozac is better than placebo at treating depression, 475 00:26:46,400 --> 00:26:50,320 Speaker 4: it is FDA approved and that's what it's not. Yes, 476 00:26:50,440 --> 00:26:52,879 Speaker 4: that's what it's evaluated. When you do blind you know, 477 00:26:53,480 --> 00:26:59,520 Speaker 4: double blind placebo control trials, they're evaluating it with placebo. 478 00:27:00,040 --> 00:27:05,160 Speaker 4: Well that's interesting and place ebo strong. But it's important 479 00:27:05,200 --> 00:27:06,000 Speaker 4: to know that. 480 00:27:06,400 --> 00:27:09,960 Speaker 3: After you take servado, do you then continue most of 481 00:27:10,000 --> 00:27:12,960 Speaker 3: the time to have some kind of management plan. So 482 00:27:13,040 --> 00:27:15,160 Speaker 3: it's not like take servado and then like never again. 483 00:27:15,200 --> 00:27:18,240 Speaker 4: Do you have to do anything If a patient meets 484 00:27:18,440 --> 00:27:22,639 Speaker 4: remission and they've done a month of you know, so 485 00:27:22,680 --> 00:27:26,679 Speaker 4: it's twice weekly for four weeks and then once weekly 486 00:27:26,760 --> 00:27:30,840 Speaker 4: for four weeks and they're at remission. I'm not gonna 487 00:27:30,840 --> 00:27:33,960 Speaker 4: want to test it much, yeah, because I want them 488 00:27:34,000 --> 00:27:37,359 Speaker 4: to have respite, yeah, right, and kind of getting their 489 00:27:37,359 --> 00:27:41,440 Speaker 4: sea legs in this new world, because you know, bad 490 00:27:41,480 --> 00:27:42,960 Speaker 4: depression is debilitated. 491 00:27:43,040 --> 00:27:43,440 Speaker 5: Yeah. 492 00:27:44,200 --> 00:27:46,920 Speaker 3: And then well you just you'll just monitor them as 493 00:27:46,920 --> 00:27:50,480 Speaker 3: that continues to make sure that's still nothing new has 494 00:27:50,520 --> 00:27:50,920 Speaker 3: come up. 495 00:27:50,920 --> 00:27:54,840 Speaker 4: Right, and then then consider tit trading down to every 496 00:27:54,840 --> 00:27:58,080 Speaker 4: other week. Okay, are you still in remission? You know? 497 00:27:58,119 --> 00:28:01,720 Speaker 4: And then I've had clients go every other one and 498 00:28:01,760 --> 00:28:02,720 Speaker 4: they've done very well. 499 00:28:02,920 --> 00:28:05,920 Speaker 3: What would you want the mental health community think about, 500 00:28:05,960 --> 00:28:11,440 Speaker 3: like therapists, practitioners like yourselves, people getting into the field, 501 00:28:11,480 --> 00:28:13,720 Speaker 3: even like texts and that, Look, what would you. 502 00:28:13,680 --> 00:28:15,840 Speaker 5: Want people to know about this treatment? 503 00:28:16,800 --> 00:28:19,560 Speaker 2: It's not as scary as we think, and to see 504 00:28:19,960 --> 00:28:23,239 Speaker 2: the improvements. I mean, I tell the story to all 505 00:28:23,280 --> 00:28:26,720 Speaker 2: of my clients, you know. I remember I've got a 506 00:28:26,800 --> 00:28:31,359 Speaker 2: gentleman that when he came to me, he tried several medicines, 507 00:28:31,680 --> 00:28:35,520 Speaker 2: and his PHQ nine, which is the Patient Health Questionnaire 508 00:28:35,960 --> 00:28:39,680 Speaker 2: depression screening that we use, he was scoring twenty seven 509 00:28:39,680 --> 00:28:42,600 Speaker 2: out of twenty seven, so he was one of the 510 00:28:42,600 --> 00:28:47,560 Speaker 2: most severely depressed people that I've ever seen. So I said, okay, 511 00:28:47,680 --> 00:28:51,160 Speaker 2: let's try this. You know, there is obviously no guarantee 512 00:28:51,160 --> 00:28:53,560 Speaker 2: that this is going to work. Let's try it and see. 513 00:28:53,600 --> 00:28:59,240 Speaker 2: We've tried many other things. So we did, and that 514 00:28:59,400 --> 00:29:03,160 Speaker 2: was probably two years ago. Today he boosters once a 515 00:29:03,200 --> 00:29:07,440 Speaker 2: month and his PHQ nine is four out of twenty seven. 516 00:29:07,800 --> 00:29:10,440 Speaker 4: Which indicates no depression or mild depression. 517 00:29:10,520 --> 00:29:12,120 Speaker 1: Right, that's incredible. 518 00:29:12,520 --> 00:29:14,840 Speaker 3: And when you say he boosters every other month, that 519 00:29:15,000 --> 00:29:17,800 Speaker 3: is kind of what Ronda was saying earlier, where you 520 00:29:17,840 --> 00:29:20,840 Speaker 3: don't have to then go on another depression medication. You 521 00:29:20,880 --> 00:29:27,160 Speaker 3: can just get this medication in lower doses or less frequent. 522 00:29:27,280 --> 00:29:30,960 Speaker 2: Maintain absolutely, and everyone's a booster schedule looks a little 523 00:29:30,960 --> 00:29:35,040 Speaker 2: differently typically for our clients for mine that are on 524 00:29:35,200 --> 00:29:37,960 Speaker 2: intramuscular and we didn't talk about that. I think we 525 00:29:38,000 --> 00:29:39,960 Speaker 2: need to talk about that a little bit. But the 526 00:29:40,000 --> 00:29:44,960 Speaker 2: intramuscular injection, our boosters are anywhere from every two weeks 527 00:29:45,000 --> 00:29:48,640 Speaker 2: to every six months. So I mean I have people 528 00:29:48,640 --> 00:29:51,719 Speaker 2: that come in about every six months and get their booster. 529 00:29:52,320 --> 00:29:55,600 Speaker 2: Now that person is taking an oral and adepressant with it, 530 00:29:55,600 --> 00:29:59,440 Speaker 2: it is recommended that they take an oral and adepressant 531 00:29:59,440 --> 00:29:59,920 Speaker 2: as well. 532 00:30:00,320 --> 00:30:02,240 Speaker 3: So I want to bring this up for a second 533 00:30:02,280 --> 00:30:05,400 Speaker 3: because last week I did an episode where somebody wrote 534 00:30:05,400 --> 00:30:09,320 Speaker 3: me in an email about some depression and anxiety they 535 00:30:09,320 --> 00:30:12,480 Speaker 3: are feeling, and their long story short, their family sent 536 00:30:12,480 --> 00:30:16,240 Speaker 3: them to this faith healer wasn't the best experience for them. Yeah, 537 00:30:16,280 --> 00:30:19,560 Speaker 3: And they were asking me, like, how do you differentiate 538 00:30:19,600 --> 00:30:23,320 Speaker 3: between like something being a battle of good and evil 539 00:30:23,400 --> 00:30:27,720 Speaker 3: instead of your body and something being about spirituality and 540 00:30:27,760 --> 00:30:30,360 Speaker 3: faith and all of that, and something being like a 541 00:30:30,400 --> 00:30:34,480 Speaker 3: chemical imbalance in your body. And the way I approached 542 00:30:34,880 --> 00:30:39,760 Speaker 3: the question was inviting in the idea of can't both 543 00:30:39,880 --> 00:30:43,040 Speaker 3: of those be things at the same time, Like can't 544 00:30:43,040 --> 00:30:46,680 Speaker 3: there be an aspect where faith can help and religion 545 00:30:46,720 --> 00:30:50,160 Speaker 3: can help the healing process and can be part of 546 00:30:50,160 --> 00:30:52,960 Speaker 3: like let's say it is part of why your brain 547 00:30:53,000 --> 00:30:56,120 Speaker 3: isn't working the way. Maybe I don't know what religion 548 00:30:56,120 --> 00:30:58,520 Speaker 3: they exactly were, but like let's say Satan came in 549 00:30:58,560 --> 00:31:01,600 Speaker 3: and like cut a wire somewhere, you know, Let's say 550 00:31:01,600 --> 00:31:02,200 Speaker 3: that is true. 551 00:31:02,520 --> 00:31:05,600 Speaker 1: Can it also be true that there are things. 552 00:31:05,280 --> 00:31:08,600 Speaker 3: In this world that God has allowed people to create 553 00:31:08,880 --> 00:31:12,760 Speaker 3: that can help fix that wire right, absolutely, Okay, So 554 00:31:13,880 --> 00:31:16,440 Speaker 3: I am a therapist obviously. People that are listening to this, 555 00:31:16,520 --> 00:31:18,560 Speaker 3: most of them know that. I have a lot of 556 00:31:18,640 --> 00:31:22,080 Speaker 3: clients that come in and I'm their first step towards 557 00:31:22,480 --> 00:31:23,480 Speaker 3: healing their depression. 558 00:31:24,280 --> 00:31:26,320 Speaker 1: And I think that's great. 559 00:31:26,040 --> 00:31:30,200 Speaker 3: I think sometimes it's okay to go see somebody for 560 00:31:30,320 --> 00:31:31,040 Speaker 3: medication first. 561 00:31:31,200 --> 00:31:32,960 Speaker 1: A lot of times they'll refer to a therapist. 562 00:31:33,280 --> 00:31:36,280 Speaker 3: But one of the conversations I have so often with 563 00:31:36,400 --> 00:31:39,520 Speaker 3: clients is, well, like, I want to be able to 564 00:31:39,520 --> 00:31:40,200 Speaker 3: do this on my own. 565 00:31:40,960 --> 00:31:41,840 Speaker 1: Isn't there like a. 566 00:31:41,840 --> 00:31:45,160 Speaker 3: Treatment or a certain type of therapy that you can do? 567 00:31:45,400 --> 00:31:47,800 Speaker 3: Like what is there out there that I can do 568 00:31:48,360 --> 00:31:50,520 Speaker 3: to fix this without that? Because I don't want to 569 00:31:50,520 --> 00:31:53,000 Speaker 3: be dependent on this and I don't want to And 570 00:31:53,040 --> 00:31:55,440 Speaker 3: that's a tough conversation to have, because, yeah, there are 571 00:31:55,480 --> 00:31:58,920 Speaker 3: clients that have healed and work through depression through talk 572 00:31:58,960 --> 00:32:02,760 Speaker 3: therapy and experiential things therapy, and there are some that 573 00:32:02,760 --> 00:32:05,160 Speaker 3: that's not gonna it's not ever gonna work because of 574 00:32:05,200 --> 00:32:08,520 Speaker 3: the chemistry and their brain, and there are things that 575 00:32:09,120 --> 00:32:14,520 Speaker 3: can help that. And the long point I'm getting at 576 00:32:14,560 --> 00:32:17,640 Speaker 3: here is, especially because we're talking about what we want 577 00:32:17,680 --> 00:32:20,680 Speaker 3: the metal, like the mental health world. To know is 578 00:32:21,240 --> 00:32:24,480 Speaker 3: that just because we're pulling in this other resource doesn't 579 00:32:24,520 --> 00:32:29,360 Speaker 3: make this resource no longer valuable exactly, exactly. That includes 580 00:32:29,440 --> 00:32:35,280 Speaker 3: your faith, that includes going on walks, that includes irapy, therapy, everything. Yes, 581 00:32:35,440 --> 00:32:37,840 Speaker 3: we have so many things that we're allowed to use together. 582 00:32:38,120 --> 00:32:41,080 Speaker 3: And saying hey, I want to try this treatment that 583 00:32:41,200 --> 00:32:43,720 Speaker 3: sounds like it could help me doesn't mean that you 584 00:32:43,760 --> 00:32:45,640 Speaker 3: have failed it this other thing, and it doesn't mean 585 00:32:45,680 --> 00:32:46,600 Speaker 3: it's not valuable. 586 00:32:47,080 --> 00:32:49,720 Speaker 2: Absolutely, It's just another piece of the puzzle. 587 00:32:49,800 --> 00:32:53,040 Speaker 4: Yeah, it's the spoken the wheel of healing, right. 588 00:32:53,480 --> 00:32:56,400 Speaker 3: Yeah, And I I know, and I say this maybe 589 00:32:56,440 --> 00:32:59,040 Speaker 3: because like it's something that I had to learn, is 590 00:32:59,080 --> 00:33:02,280 Speaker 3: that therapy is always going to be the answer. 591 00:33:02,800 --> 00:33:05,120 Speaker 1: Sometimes it's the answer. A lot of times it's part 592 00:33:05,160 --> 00:33:05,800 Speaker 1: of the answer. 593 00:33:06,360 --> 00:33:09,920 Speaker 3: And it's important to be open minded and be curious 594 00:33:10,080 --> 00:33:13,920 Speaker 3: and have conversations about these kinds of treatments because if 595 00:33:13,920 --> 00:33:16,480 Speaker 3: we just shut all these down because we shouldn't be 596 00:33:16,600 --> 00:33:20,120 Speaker 3: using I mean, I remember when there's a lot of 597 00:33:20,160 --> 00:33:22,920 Speaker 3: debate around harm reduction in the treatment world. 598 00:33:22,960 --> 00:33:24,240 Speaker 1: I mean, that's always going to be a debate. 599 00:33:25,120 --> 00:33:29,280 Speaker 3: We can shut those conversations down. However, I wonder what 600 00:33:29,280 --> 00:33:31,920 Speaker 3: would happen if we opened ourselves up to them, right, 601 00:33:31,960 --> 00:33:34,520 Speaker 3: It doesn't mean we're going to be, you know, telling 602 00:33:34,520 --> 00:33:36,360 Speaker 3: all of our clients so you can just like smoke 603 00:33:36,440 --> 00:33:38,680 Speaker 3: whenever you want to. Like, that doesn't mean what we're saying. 604 00:33:39,760 --> 00:33:43,400 Speaker 3: There's so much power in learning something that could be 605 00:33:43,440 --> 00:33:48,200 Speaker 3: helpful from being open to the conversation and what I 606 00:33:48,200 --> 00:33:52,160 Speaker 3: would want if there's not so much just potential clients 607 00:33:52,200 --> 00:33:55,720 Speaker 3: out there and humans and individuals, but mental health professionals 608 00:33:55,760 --> 00:33:57,000 Speaker 3: who are like, what kind. 609 00:33:56,800 --> 00:33:58,960 Speaker 1: Of mean you don't have to use it. 610 00:33:59,360 --> 00:34:01,880 Speaker 3: You don't have to to encourage people using it, You 611 00:34:01,880 --> 00:34:04,640 Speaker 3: don't have to do any of that. My encouragement is 612 00:34:04,880 --> 00:34:07,440 Speaker 3: to just be curious about it and maybe learn about it, 613 00:34:08,040 --> 00:34:10,879 Speaker 3: because even through learning about it, you might learn something 614 00:34:10,920 --> 00:34:13,759 Speaker 3: about the brain that you didn't now, or something about 615 00:34:13,760 --> 00:34:16,719 Speaker 3: these other medications that you've been fine with your whole 616 00:34:16,800 --> 00:34:18,279 Speaker 3: life that might shock you. 617 00:34:18,400 --> 00:34:22,120 Speaker 4: Well, Selena and I truly feel, and this is our bias, 618 00:34:22,719 --> 00:34:26,840 Speaker 4: that medicine only makes space for the work that's good. 619 00:34:27,040 --> 00:34:31,880 Speaker 4: And you know, so we highly encourage therapy, and especially 620 00:34:31,920 --> 00:34:36,000 Speaker 4: weekly therapy while they're getting this treatment because of the 621 00:34:36,040 --> 00:34:40,120 Speaker 4: neuroplasticity and these neuronal connections they are going to develop 622 00:34:40,360 --> 00:34:41,520 Speaker 4: so much more insight. 623 00:34:42,200 --> 00:34:45,880 Speaker 2: Oh yeah, I've had therapists, you know, contact me and 624 00:34:46,120 --> 00:34:49,920 Speaker 2: you know, we're collaborating about a client that's going through treatment, 625 00:34:49,960 --> 00:34:53,280 Speaker 2: and they're like, oh my goodness, it's like the wall 626 00:34:53,400 --> 00:34:56,960 Speaker 2: came down. They were able to drop in and access 627 00:34:57,160 --> 00:34:59,800 Speaker 2: places of their trauma or what. 628 00:35:00,200 --> 00:35:04,440 Speaker 3: They're not in that protective mode anymore. And if we 629 00:35:04,480 --> 00:35:10,240 Speaker 3: can't get through that protective wall and it's there because 630 00:35:10,360 --> 00:35:12,440 Speaker 3: it believes it needs to be there, or it was 631 00:35:12,480 --> 00:35:15,040 Speaker 3: put there because it needed to be there at some point, 632 00:35:15,280 --> 00:35:17,879 Speaker 3: well then there's not much we can do. So I 633 00:35:17,920 --> 00:35:21,320 Speaker 3: love that. Will you say it again that medicine. 634 00:35:21,360 --> 00:35:24,120 Speaker 5: Only makes space for you to jus the work? 635 00:35:24,680 --> 00:35:25,919 Speaker 1: Did you come up with that on your own? 636 00:35:26,320 --> 00:35:32,760 Speaker 4: I think I am regurgitating information from a former psychiatrist 637 00:35:32,760 --> 00:35:33,000 Speaker 4: that I. 638 00:35:33,040 --> 00:35:33,640 Speaker 5: Used to work with. 639 00:35:34,960 --> 00:35:36,960 Speaker 1: Any of those things that stick with you. 640 00:35:36,680 --> 00:35:40,520 Speaker 4: Who is he comes out quite frequently and too, I 641 00:35:40,560 --> 00:35:41,719 Speaker 4: have that most respect for. 642 00:35:42,080 --> 00:35:44,840 Speaker 3: There are two quotes that one of my bosses that 643 00:35:44,920 --> 00:35:48,240 Speaker 3: that treatment center said to me that I find myself. 644 00:35:47,880 --> 00:35:49,640 Speaker 1: Saying over and over and over again. 645 00:35:49,960 --> 00:35:52,040 Speaker 3: One of them is, this is when I was very 646 00:35:52,080 --> 00:35:54,360 Speaker 3: worried about what my clients thought about me. Was what 647 00:35:54,440 --> 00:35:56,080 Speaker 3: other people think of you as none of your business 648 00:35:56,600 --> 00:35:59,880 Speaker 3: that was so powerful as a therapist. And then the 649 00:36:00,120 --> 00:36:02,800 Speaker 3: other is, which you'll get this why she had to 650 00:36:02,840 --> 00:36:05,120 Speaker 3: say this so often, but other people's chaos is not 651 00:36:05,160 --> 00:36:09,719 Speaker 3: your emergency? Yes, yes, because everything at that place. I 652 00:36:09,840 --> 00:36:11,960 Speaker 3: was like, oh, there's another fire I have to put out, 653 00:36:12,000 --> 00:36:14,880 Speaker 3: And she's like, why you don't let them sit in 654 00:36:14,920 --> 00:36:18,399 Speaker 3: that they'll figure it out. So that's funny that it's 655 00:36:18,520 --> 00:36:21,279 Speaker 3: the things that stick. Okay, is there anything that we 656 00:36:21,360 --> 00:36:24,120 Speaker 3: haven't said that you would want to offer to somebody 657 00:36:24,160 --> 00:36:28,800 Speaker 3: who might be experiencing treatment resistant depression? Who's like, wait, 658 00:36:28,840 --> 00:36:31,680 Speaker 3: I've never heard of about this? Is this is new? 659 00:36:31,760 --> 00:36:34,400 Speaker 1: And I am getting a little curious just that. 660 00:36:34,480 --> 00:36:37,000 Speaker 2: I mean, by no means is it an end all 661 00:36:37,000 --> 00:36:40,800 Speaker 2: be all? You're all you know, it is again another 662 00:36:40,840 --> 00:36:46,840 Speaker 2: tool in the toolbox, but we have experienced the goodness 663 00:36:46,880 --> 00:36:47,319 Speaker 2: from it. 664 00:36:48,000 --> 00:36:50,560 Speaker 4: Our clients should have. I mean, to see the face 665 00:36:50,960 --> 00:36:53,160 Speaker 4: of someone with a pH Q nine of twenty six 666 00:36:53,160 --> 00:36:55,320 Speaker 4: out of twenty seven, or twenty seven out of twenty seven, 667 00:36:55,440 --> 00:36:58,560 Speaker 4: you know, it's a different person it is to see, 668 00:36:59,080 --> 00:37:03,560 Speaker 4: to see their face shift in two weeks to the 669 00:37:03,719 --> 00:37:06,120 Speaker 4: he's a musician that would not pick up the guitar 670 00:37:07,239 --> 00:37:11,680 Speaker 4: and is now playing. You know, It's it's unreal to 671 00:37:11,760 --> 00:37:14,239 Speaker 4: see and also to see the progress they make with 672 00:37:14,280 --> 00:37:17,480 Speaker 4: their therapists and the insight that they develop and the 673 00:37:17,600 --> 00:37:20,040 Speaker 4: life they get back. I have the sweetest client that 674 00:37:20,120 --> 00:37:24,840 Speaker 4: another psychiatric provider referred for treatment and every time he 675 00:37:24,920 --> 00:37:27,120 Speaker 4: comes to these I've got to give you a hug. 676 00:37:27,200 --> 00:37:30,520 Speaker 4: You have changed my life so much. I want people 677 00:37:30,560 --> 00:37:31,200 Speaker 4: to have hope. 678 00:37:31,280 --> 00:37:32,239 Speaker 1: And that's another thing. 679 00:37:32,400 --> 00:37:36,799 Speaker 2: Like other providers can refer to us just for an 680 00:37:37,040 --> 00:37:40,160 Speaker 2: catamaine evaluation and stay with. 681 00:37:40,120 --> 00:37:43,560 Speaker 5: Their current writer and we collaborate with them. 682 00:37:43,960 --> 00:37:46,200 Speaker 1: Okay, you don't have to leave your your home banks, 683 00:37:46,200 --> 00:37:46,759 Speaker 1: absolutely no. 684 00:37:46,760 --> 00:37:49,239 Speaker 3: No. I really scary when you find somebody that you 685 00:37:49,760 --> 00:37:50,720 Speaker 3: trust and value. 686 00:37:50,920 --> 00:37:54,520 Speaker 4: Right, So, any psychiatric provider can refer to us and 687 00:37:54,560 --> 00:37:57,719 Speaker 4: will ask for a release of information, will ask for 688 00:37:57,760 --> 00:38:00,960 Speaker 4: a release of information from their medical provider, so we 689 00:38:01,000 --> 00:38:03,040 Speaker 4: can all be on the same page general release for 690 00:38:03,080 --> 00:38:05,719 Speaker 4: their therapist because we want to collaborate with them too, 691 00:38:06,640 --> 00:38:08,920 Speaker 4: and we could see if it would be a good 692 00:38:08,920 --> 00:38:11,600 Speaker 4: fit for them. There is a time commitment that I 693 00:38:11,600 --> 00:38:14,960 Speaker 4: think they need to understand. It's twice a week for 694 00:38:15,040 --> 00:38:19,360 Speaker 4: three weeks with kenemine and they can't drive. So that's 695 00:38:19,840 --> 00:38:22,279 Speaker 4: for people that most of us that have to work 696 00:38:22,320 --> 00:38:23,200 Speaker 4: and most of us that. 697 00:38:23,200 --> 00:38:24,800 Speaker 5: Have life that's hard. 698 00:38:25,200 --> 00:38:25,719 Speaker 1: Yeah. 699 00:38:25,920 --> 00:38:28,480 Speaker 4: And with spravado it's twice a week for four weeks 700 00:38:28,600 --> 00:38:30,320 Speaker 4: and then once a week thereafter. 701 00:38:30,800 --> 00:38:31,160 Speaker 1: Okay. 702 00:38:31,760 --> 00:38:33,600 Speaker 3: So before we close this because I just want to 703 00:38:33,600 --> 00:38:36,080 Speaker 3: clarify this because I don't know if I even heard 704 00:38:36,080 --> 00:38:41,200 Speaker 3: this correct. Spervado is FDA approved for the treatment of depression? 705 00:38:42,320 --> 00:38:45,839 Speaker 3: Is there another form of this that is used that's 706 00:38:45,920 --> 00:38:48,799 Speaker 3: not FDA approved or is there another FDA approved form 707 00:38:48,840 --> 00:38:49,040 Speaker 3: of this? 708 00:38:49,640 --> 00:38:53,960 Speaker 4: Ketamine was approved FDA approved a long time ago, and 709 00:38:54,000 --> 00:38:57,400 Speaker 4: so it's used off label for the treatment of treatment 710 00:38:57,440 --> 00:39:01,720 Speaker 4: resistant depression, okay, And it will never for ketemine itself 711 00:39:01,719 --> 00:39:07,120 Speaker 4: will never be submitted for reapproval for treatment resistant depression, okay, 712 00:39:07,280 --> 00:39:08,080 Speaker 4: because it was. 713 00:39:08,000 --> 00:39:12,160 Speaker 2: Originally proved for or as an anesthetic. 714 00:39:12,760 --> 00:39:13,080 Speaker 1: Okay. 715 00:39:13,120 --> 00:39:16,040 Speaker 3: I'm learning about the medication world, okay, because sravado was 716 00:39:16,040 --> 00:39:18,879 Speaker 3: a little bit different. They you said, they changed one thing, yep, 717 00:39:18,920 --> 00:39:23,640 Speaker 3: and then now it's the asketamine asketamine Okay, So that's 718 00:39:23,680 --> 00:39:26,279 Speaker 3: why that is like a new approved thing. Yes, So 719 00:39:26,440 --> 00:39:29,880 Speaker 3: ketamine got FDA approved for the use of. 720 00:39:30,400 --> 00:39:33,280 Speaker 5: Being an anesthetic as an anesthetic. 721 00:39:32,719 --> 00:39:35,640 Speaker 3: And because it's FDA approved, we can prescribe it for 722 00:39:35,719 --> 00:39:36,280 Speaker 3: other things. 723 00:39:37,040 --> 00:39:38,920 Speaker 4: Many drugs are prescribed off flabel. 724 00:39:39,000 --> 00:39:39,960 Speaker 1: Okay, I didn't know that. 725 00:39:40,160 --> 00:39:41,400 Speaker 5: Yeah, but it's. 726 00:39:41,320 --> 00:39:45,560 Speaker 4: Really important to know. I mean that spravado would never 727 00:39:45,640 --> 00:39:48,240 Speaker 4: be here without ketymine being here first. 728 00:39:48,760 --> 00:39:50,080 Speaker 1: Okay. Well that's helpful. 729 00:39:50,320 --> 00:39:53,760 Speaker 3: Yeah, we saw that, and then that was created outside 730 00:39:53,760 --> 00:39:56,920 Speaker 3: of Okay, all right, well it sounds like there are 731 00:39:56,960 --> 00:39:59,440 Speaker 3: some options out there for you guys. And you do 732 00:39:59,560 --> 00:40:03,520 Speaker 3: SPAVI and the other form can other forms, yes, okay, 733 00:40:03,760 --> 00:40:04,360 Speaker 3: and that. 734 00:40:04,280 --> 00:40:07,120 Speaker 1: Is an Is that an injection? It is? Okay, do 735 00:40:07,160 --> 00:40:09,600 Speaker 1: you have a preference or does it depend on the client. 736 00:40:10,000 --> 00:40:11,120 Speaker 5: So it depends on the client. 737 00:40:11,160 --> 00:40:14,000 Speaker 2: I mean the buy availability of the medication is higher 738 00:40:14,440 --> 00:40:18,560 Speaker 2: getting an injection, but I think we see just as 739 00:40:18,680 --> 00:40:21,320 Speaker 2: good of results okay in the nasal spray. 740 00:40:21,320 --> 00:40:22,640 Speaker 5: It just takes a little longer to get there. 741 00:40:22,880 --> 00:40:26,399 Speaker 3: Oh okay, cool, all right, Well, thank you for having 742 00:40:26,400 --> 00:40:27,319 Speaker 3: this conversation with me. 743 00:40:27,600 --> 00:40:28,800 Speaker 5: Thank you, Thank you, Bully. 744 00:40:29,080 --> 00:40:30,800 Speaker 1: It offered some new information. 745 00:40:31,000 --> 00:40:33,080 Speaker 3: I have an assumption that a lot of people are 746 00:40:33,120 --> 00:40:36,759 Speaker 3: gonna be like what and some people are gonna be like, oh, yeah, 747 00:40:36,760 --> 00:40:39,320 Speaker 3: I've heard about this, and I turned that conversation away 748 00:40:39,560 --> 00:40:41,759 Speaker 3: and some people are gonna probably be thinking, I've been 749 00:40:41,800 --> 00:40:44,560 Speaker 3: wanting to learn about this, So we're gonna have a 750 00:40:44,560 --> 00:40:47,120 Speaker 3: lot of different opinions. If you have any questions, If 751 00:40:47,120 --> 00:40:49,960 Speaker 3: you're listening to this and you have any questions, feedback, anything, 752 00:40:50,680 --> 00:40:54,480 Speaker 3: you can email Katherine at nied Therapy podcast dot com. 753 00:40:54,680 --> 00:40:57,319 Speaker 3: Do you have questions for Selena and Ronda, you can 754 00:40:57,360 --> 00:41:00,400 Speaker 3: actually send those there And if it's a question that 755 00:41:00,400 --> 00:41:03,680 Speaker 3: we can answer on one of the Wednesday Couch Talks episodes, 756 00:41:03,719 --> 00:41:06,160 Speaker 3: we might be able to do that as well. If 757 00:41:06,160 --> 00:41:09,960 Speaker 3: you just want to contact them, Where can they find you? Guys? 758 00:41:10,160 --> 00:41:12,560 Speaker 2: So our phone number is six one five eight six 759 00:41:12,719 --> 00:41:16,360 Speaker 2: one one one one four and our website is Willow's 760 00:41:16,400 --> 00:41:17,760 Speaker 2: healthandrecovery dot com. 761 00:41:17,920 --> 00:41:20,120 Speaker 3: If you want to find me, you can do that 762 00:41:20,719 --> 00:41:24,000 Speaker 3: on Instagram at you Need Therapy Podcasts and at Kat 763 00:41:24,080 --> 00:41:27,040 Speaker 3: dot Defada. And until Wednesday, I hope you guys are 764 00:41:27,040 --> 00:41:29,799 Speaker 3: having the day you need to have and I'll talk 765 00:41:29,840 --> 00:41:30,399 Speaker 3: to you later.