As you may know, the CONVICTS gang is très stoked about the potential of psychedelic assisted therapy. That’s why we called up the good people at Mindbloom, a ketamine-therapy provider on the cutting edge of psychedelic research.
We sent a list of questions to Dr. Leonardo Vando, Mindbloom’s Medical Director, about the past, present, and future of psychedelic therapy. Read what he had to say below.
Can you tell us a bit about Mindbloom’s mission?
Our mission is to transform lives to transform the world. To do this, we must radically expand access to the ketamine treatment modality, and we achieve this in a number of ways. One way is reducing the cost of ketamine treatments, which we’ve done by 75%. Another way is accessibility through telemedicine, since most people seeking treatment aren’t in proximity to a treatment center or struggle to fit a visit into their busy schedules.
We’re also dedicated to achieving outsized clinical results for our clients. Across three important vectors—efficacy, time to benefit, and side effects—ketamine has shown to be significantly more effective than the average SSRI.
How did the company come about? Where did this passion for psychedelic therapy come from?
Mindbloom arose from a collective desire to expand access to science-backed psychedelic medicines, such as ketamine, to improve mental outcomes for millions of clients. I can personally speak to this mission, having felt limited by the amount of people I could treat in my own private practice. Many of us at Mindbloom have witnessed or experienced the healing power of psychedelic medicines first-hand, which adds to our passion and dedication to deliver tremendous results for our clients. I encourage your audience to read more about Mindbloom’s founding here, as it takes a more personal tone for our founder and CEO, Dylan Beynon.
What should someone new to psychedelic therapy know?
A common question for those new to psychedelic therapy centers around the legality of the treatment we provide. The ketamine treatment modality is safe, science-backed, and clinically prescribed.Our Medical team, myself included, have decades of experience in psychedelic medicine research and private practice. Our Mindbloom Guides collectively have decades of experience helping to facilitate personal growth and healing through areas of psychedelic integration.
What is revolutionary about psychedelic therapy?
The most important aspect of this revolutionary treatment are the superior outcomes compared to traditional prescription drugs for anxiety and depression. Clinical outcomes are our top priority as medical providers and are the core of Mindbloom’s mission.
Ketamine treatment studies show a 60-75% response rate, and a significant antidepressant response within 24 hours. In contrast, conventional antidepressant medications showed a 40–47% response rate and a lag time of weeks to months before onset. At Mindbloom, over 80% of clients with depression or anxiety see a reduction in symptoms after four sessions. To say we’re excited about the continued potential of psychedelic medicine, and ketamine treatment specifically, is an understatement.
For someone who has experimented with psychedelics in a non-therapeutic setting--how is the therapeutic experience different?
What is the state of psychedelic therapy in 2021?
In recent years we’ve seen promising developments in how mental health is discussed and treated. In 2020 psychedelic therapy became a much larger part of the discussion.
In my opinion, 2021 is psychedelic therapy’s breakout year. People are increasingly open to psychedelics as a solution for persistent or treatment-resistant depression and anxiety, and providers are increasingly open to administering this potentially life-changing treatment in response. From a regulatory perspective, we’re seeing impressive results and a likely FDA approval following Phase III clinical trials for MDMA for PTSD —the final phase before approval.
Mindbloom is proud to be at the forefront of the psychedelic medicine movement, as we were one of the first to offer fully virtual psychedelic treatment in response to the growing mental health needs here in the U.S., especially after COVID’s arrival.
What does a guided psychedelic therapy session look like?
First, it’s important to give a bit of context into how the client arrives at their first at-home session.
Clients start their Mindbloom program with a video consultation with a psychiatric clinician, where we learn about the client’s medical history, current physical and mental health, and goals for treatment and determine if ketamine therapy is a good fit. If approved for treatment, clients are paired with a Mindbloom Guide who helps them navigate their program and prepare for their first ketamine therapy session, which we call a "virtual visit."
Before the first session, we ship a "Bloombox" to each client’s home, which includes both medical (e.g. blood pressure cuff) and experiential (e.g. luxury eye mask, journal) items. The client will also enlist a “peer treatment monitor” (PTM) —typically a close friend or loved one— to be with them during the experience. These aspects help to facilitate a safe and seamless journey for our clients.
During the session, their Mindbloom Guide helps them cultivate a positive mindset and set up their physical space. With their Bloombox items at-hand, and their PTM present, the client then dives into their experience with the medicine, which lasts around 45 minutes to an hour. After the experience, they’re given time to journal about what surfaced, or any specific thoughts that arose.
Immediately after the first session, the guide/client team helps the client solidify learning and insights from the experience, and develops a treatment plan for their remaining sessions. As you become comfortable with the process, subsequent sessions become more self-led. However, your Guide is always there for you via unlimited text, and your clinician is on standby if you need to make any adjustments to your medicine.
How, exactly, does it work?
The neuroscience of ketamine shows that ketamine affects different neurotransmitters and receptors than medicines like antidepressants (SSRIs). The pathways ketamine affects are shown to increase neuroplasticity, or our brain’s ability to create new neural pathways, rather than increase the concentration of serotonin (like SSRIs).
In combination with promoting neuroplasticity, ketamine helps to reduce activity in the default mode network (DMN), which sustains everyday states of consciousness. The DMN can often involve negative patterns, like rumination, the brain can get stuck in.
These mechanisms are what help facilitate and solidify the behavioral changes most clients are seeking in a therapeutic sense. An example of this could be a client’s set intention to be more kind to themselves. The momentum from treatment can help them become more mindful of self-talk or the negative thoughts that surface, helping them to consider and correct this behavior rather than feeding the loop.
More simply, the experience and its short and long-term effects give clients “breathing room” to create lasting change, which may be difficult given how disruptive depression, anxiety, and other conditions can be.
Can you walk us through the patient “experience” or what they see or feel?
Each client’s experience is vastly different from the next. Our founder, Dylan, once said “I’m not a believer in attempting to describe indescribable experiences,“ which I tend to agree with.
There are key phrases or words that come up often when a client describes the experience, like “warmth,” “openness,” “one with the universe,” and “filled with love and gratitude.” Some describe it as a deep meditative state in which profound thoughts surface. But again, what each person feels, sees, emotes, or experiences is unique to their own experience.
We have a great resource that helps to sum the experience.
What’s the current status of other psychedelic therapies (MDMA, psilocybin)?
MDMA and psilocybin as a whole are making progress in the multi-phased FDA drug approval process. As with any compound up for approval, their status is tied to their treatment application. For example, MDMA-assisted psychotherapy for PTSD specifically is in Phase 3 of FDA approval, which refers to large-scale testing of safety and effectiveness with thousands of patients.
Our psychedelic medicine pipeline resource is a great place to keep up with the research and approval statuses of ketamine, MDMA, and psilocybin.
How (when implemented) will those therapies differ from ketamine therapy?
I’d anticipate that they’d differ greatly in protocol. The FDA is expected to introduce strict guidelines for how these drugs will be used, and they likely won’t be available through telemedicine as ketamine is now.
Also, there are distinct differences in the biological mechanisms on which each drug acts, and the altered states produced by these drugs can last 6+ hours, whereas the ketamine experience is much shorter in duration.
As a result of these guidelines, these treatments will likely be very expensive unless covered by insurance. In contrast, Mindbloom has helped reduce costs for ketamine treatment by over 70%, helping to increase access to a psychedelic therapy modality that’s available now.
How do these therapies interact with other practices or therapies (ie, mindfulness or talk therapy, etc)?
The beauty of psychedelic therapy is that it can be both a singular or supplementary healing experience for clients. This means clients can continue with, and often benefit from, meditation or talk therapy in parallel to their treatment with psychedelic medicine. It’s all about facilitating growth and healing in a way that provides the most benefit to the client.
What do you hope to see Mindbloom (and psychedelic therapy at large) achieve?
Speaking generally, increased access to psychedelic medicines, continued expansion of research into new applications and compounds, and expedition of medicinal approvals through governing bodies like the FDA are what we’re all working toward.
It should come as no surprise that access is on Mindbloom’s list as well. This means increased access to treatment for more people by expanding where our partner clinicians treat (more states) and what they treat (more conditions). We’re laser-focused on building the most clinically efficacious and transformational client experiences through technology, content, and human care. We’re also focused on growing our mission-obsessed team —we’re hiring!
What would you tell someone interested in undergoing psychedelic therapy?
The most important advice I can give is to make an informed decision about whether this treatment is right for you, and if you decide to continue with treatment, keep an open mind and set realistic expectations.
This treatment modality has the potential to change your life in profound and lasting ways, but psychedelic medicine isn’t a “magic pill.” Treatment can surface heavy topics or expose areas of your life where behavioral change is required, so be prepared to show up for yourself and do the work.
I often tell clients that ketamine treatment is like surfing: The wave will come, and it will move you, but you have to do some paddling to truly ride it.