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Why did ketamine clinics suddenly become so popular? Why are so many ketamine clinics closing?
Ketamine clinics (brick-and-mortar and virtual) are spreading across the US and promoting the drug as a therapy for depression and other mental health conditions. However, the treatments are expensive and many clinics are struggling to stay afloat.
Here’s a look at the pop-up of ketamine clinics, why they’re so popular, and why many aren’t surviving.
Ketamine Clinics Are Popping Up Everywhere
Ketamine clinics have been spreading across the US since 2020, when the Trump administration introduced regulatory changes that made it easier for clinicians to treat patients by telemedicine. These changes allowed the remote prescribing of controlled substances and made many treatments more accessible and affordable. They also launched an entire industry of companies offering in-person and at-home ketamine treatments—an industry now troubled by growing pains and many ketamine clinics are closing.
The use of ketamine to treat depression, anxiety, and PTSD predates the pandemic. In 2019, the Food and Drug Administration approved one form of the drug—a nasal spray called esketamine—for treatment-resistant depression and acute suicidal thinking.
What Do Regulators and Scientists Say?
At some brick-and-mortar ketamine clinics, patients receive intravenous infusions or intramuscular injections of the drug. Other patients, including those who see providers remotely, use a nasal spray or tablet. The nasal spray is the version the FDA approved for treating depression. Its protocol requires that 1) it be used alongside an oral antidepressant, and 2) a health care provider monitor patients for at least two hours after each dose because of the risk of sedation or dissociation. But scientists say that despite the FDA approval, they’re not yet sure how the drug works in the brain to mitigate symptoms of depression.
Early studies demonstrated that ketamine can quickly relieve the symptoms of depression. But it’s unclear whether the gains made early in treatment can be maintained or whether ketamine is safe for extended use. While other psychedelics don’t seem to be addictive for most people, patients can become dependent on ketamine. Critics also note that ketamine appeals to particularly vulnerable patients—those with severe depression, suicidal ideation, or other mental health conditions that haven’t responded to traditional treatments.
Regardless, many hope that it will revolutionize depression treatment. Researchers have also found that high doses over prolonged periods can result in lower urinary tract symptoms, such as bladder damage that requires surgical reconstruction. Further, ketamine abuse can lead to cognitive impairment. Advocates say these side effects don’t occur at therapeutic dosages. However, a lack of oversight makes it difficult to determine the prevalence of side effects.
Why Are Ketamine Clinics Closing?
Observers say that some ketamine clinics are struggling because the industry expanded too quickly, based on investors’ unrealistic expectations. (When interest in ketamine first surged, “start your own ketamine clinic” courses began to pop up, to the concern of critics.) Providers say it’s challenging to turn a profit because the clinics offer only one treatment, which health insurance doesn’t cover. Even when patients pay $300 to $1,000 per session—a price that presents an obstacle for many—the costs of delivering high-quality care and advertising their services (as some startups do with persistent targeted ads) are high.
A chain called Ketamine Wellness Centers (KWC) abruptly closed its 13 clinics in March. Its patients said they didn’t have sufficient time to obtain their medical records or find a new provider to continue their treatment. Another chain, called Field Trip Health and Wellness, has closed five of its locations in 2023, citing “financial pressures.”
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