Case Study: How Odyssey Alleviated Depression Symptoms for a 37 Patient Cohort

Learn how EntheoMed’s Odyssey lowered depression scores for 37 treatment-resistant patients through its innovative method of ketamine-assisted therapy.

Odyssey Clinic:

EntheoMed Kelowna

Case Study Cohort Size:

37

Time:

2022-2023

About the Odyssey Method

Odyssey is a mental health treatment, offering fast-acting relief for common conditions through a holistic method of ketamine-assisted therapy.

With a focus on personal care, Odyssey supports lasting wellness through a blend of transformative medicine, supportive counselling and mind+body integration practices.

Background on Canadian Mental Health

 

Mental illness is a leading cause of disability in Canada (Institute for Health Metrics and Evaluation, 2015; Lim et al., 2008; Mental Health Commission of Canada, 2014).

In any given year, 20% of Canadians experience a mental illness, and by the age of 40, 50% have had – or will have – a mental illness (Dobson et al., 2020). Accounting for a large proportion of mental illnesses are mood disorders.

Major depression is the most prevalent mood disorder affecting approximately 5.4% of the Canadian population (Dobson et al., 2020). Depression can cause severe challenges and is characterized by persistent sadness, feelings of hopelessness, loss of interest in pleasurable activities, and sleep disturbance.

Unfortunately, amid the COVID-19 pandemic, there has been a rise in major depressive disorder (MDD) amongst adults (Liu et al., 2021). Specifically, in the Fall of 2020, 15% of Canadian adults screened positive for MDD, with the number rising to 19% in the Spring of 2021 (Liu et al., 2021).

Alarmingly, it is estimated that only half of Canadians who experience a major depressive episode receive “potentially adequate care” (Patten et al., 2016). Moreover, for those who do receive care, existing pharmacological treatments are relatively lacking – with 30-40% patients deemed as “treatment resistant” (Papp et al., 2022).

New pharmacological approaches are sorely needed.

One treatment that is beginning to help fill this gap is ketamine.

 

Ketamine is an exemplar fast-acting glutamatergic anti-depressant which has been shown through clinical trials and meta-analyses to be effective for MDD, including in patients previously designated as treatment-resistant (e.g., Marcantoni et al., 2020; Phillips et al., 2019).

However, ketamine’s antidepressant effects, when administered as a standalone pharmacological treatment, are typically relatively short-lasting – most patients relapse after approximately 2 weeks (Marcantoni et al., 2020).

Emerging evidence suggests two avenues to extend the therapeutic effects of ketamine: (1) providing multiple infusions within a given period of time (e.g., 6 infusions in six weeks; Kryst et al., 2020), (2) or administering ketamine alongside psychotherapeutic support and adjunctive interventions (Drozdz et al., 2022; Price et al., 2022).

Our proprietary Odyssey Method is a unique approach to ketamine-assisted psychotherapy that draws from the latest perspectives in somatic, trauma-focused, transpersonal, and psychedelic-assisted therapies.

This approach is aimed at leveraging synergies between the psychological and neurobiological effects of ketamine, psychotherapy, and targeted adjunctive interventions to facilitate lasting change.

Methodology

 

Selection Criteria
The cohort consists of patients suffering from clinically diagnosed depression that were referred to our clinic by their physician/psychiatrist.

Sample Size
37 Patients

Assessment Tools
Depression severity was assessed using the PHQ-9 standardized measure.

Duration
Patients were enrolled in the clinic on a rolling basis and assessed at baseline and at multiple follow-up time-points (1-week, 1-month, 3-months).

Treatment Overview

 

Odyssey Method Details
The cohort consists of patients suffering from clinically diagnosed depression that were referred to our clinic by their physician/psychiatrist.

Medicine
Therapeutic dose of intramuscular ketamine

Counselling
50 minute counselling pre-session and 50 minute counselling post-session.

Mind + Body Integration
Patients were enrolled in Odyssey Online – an educational learning portal filled with guidance on mind + body integration practices.

Odyssey Cohort Results

Chart shows a significant drop in PHQ9 scores at approximately 3-months post treatment.

There was a statistically significant reduction in PHQ-9 scores between baseline and the 3-month follow-up.

 

The number of patients that qualified for severe or moderately severe depression decreased by >50% at the 3-month follow-up.

 

In addition, 4 times as many patients no longer qualified for depression, with a PHQ-9 score less than 10.

Frequently Asked Questions

Ketamine-assisted therapy (KAT) combines the use of ketamine with psychotherapy as a treatment for mental health and chronic pain. Ketamine is proven to be a safe medication, used in hospital settings since 1970. Studies for its novel application for depression began in 2000 and is supported by a rapidly growing body of evidence.

Ketamine is not a magic pill that can solve any problem – but the insights the experience allows can catalyze lasting positive change, deep healing and transformation – with the support of psychotherapy and holistic lifestyle shifts.

Yes, ketamine was originally approved as an anesthetic by the FDA in 1970. It’s known for its safety profile, especially because it doesn’t suppress breathing like other anesthetics. While it has anesthetic properties, it’s used in much lower doses in the context of KAT, aiming for its psychoactive and transformative effects.

Ketamine boosts neuroplasticity, especially in the prefrontal cortex, a vital area for regulating emotions and attention. This enhances the brain’s ability to form new positive connections and break away from negative thought loops.

Ketamine is an NMDA receptor antagonist, and that accounts for many of its actions. The mechanism by which ketamine exerts its antidepressant effect is still being elucidated, and is undergoing much research. Studies show a statistically significant reduction in suicidality and depressive symptoms with the use of ketamine in sub-anesthetic doses.

It induces dissociative anesthesia, a trance-like state providing pain relief, sedation, and amnesia. The distinguishing features of ketamine anaesthesia are preserved breathing and airway reflexes, stimulated heart function with increased blood pressure, and moderate bronchodilation.

For pain patients, ketamine can help ‘reset’ pain receptors to lower the frequency and intensity of pain signals over time. For mood disorder patients, ketamine has a number of therapeutic effects such as helping excite new neural pathways that improve mood, sleep, and more.

With psychotherapy and integration, KAT may improve psychological flexibility so that patterns of behavior are modified in a positive way.

We are a private pay healthcare clinic and at this time, do not directly bill insurance companies. We cannot guarantee your insurance or benefit company will provide coverage for this treatment. We will provide an invoice for you to submit for any repayment available to you. Currently, Ketamine treatments are not covered by the MSP Services Plan.

MSP – No, it is not covered under the provincial health plan.

Insurance – Insurance companies differ widely in their policies for reimbursement. We suggest checking with your provider ahead of time.

The cost of a therapeutic Ketamine experience is $1400. There is a one-time $400 Ketamine Therapy consultation fee for a physical and psychiatric screening to ensure the safety of the treatment. This will not be charged again for any further treatment with us. Other pricing options are available after the initial treatment.

Once you have undergone your Ketamine Therapy Consultation and been assessed by our medical team, you can be scheduled for treatment.

This varies for each individual. Some might benefit from a single session, while others might undergo multiple sessions. It’s a personal journey, and the number of sessions will depend on your unique needs and therapeutic goals.

SSRIs target the serotonin system in the brain and usually take a few weeks to show effects. Ketamine, on the other hand, targets the glutamate system, resulting in immediate effects often within hours. Ketamine offers a unique psychological experience which can provide deeper insights and healing.

During the assessment phase, members of the medical team will evaluate your needs to determine if KAT is the right fit for you. In general, those seeking relief from conditions like depression, anxiety, and PTSD might benefit, but each individual’s needs and history are considered. You can also view our Eligibility Criteria to learn more.

Some patients may feel tired, groggy, or experience mild nausea after a KAT session. Often these side effects will resolve on their own after a full night’s sleep.

Odyssey’s approach to KAT is a comprehensive, multi-phase experience. It begins with a thorough assessment, followed by a preparation phase, personalized counselling, and integration guidance. This holistic approach ensures patients not only undergo the ketamine session but are well-prepared beforehand and receive ample support afterwards. The treatment emphasizes setting clear intentions and integrating the insights from the sessions into daily life.

Preparation is a key part of the Odyssey experience. In the Preparation phase, you’ll meet one-on-one with a psychedelically-aware counsellor. This session will help you explore your personal history, current needs, and set a clear intention for the experience. Reflecting on what you want to achieve and discussing potential goals is crucial.

During a session, you’ll be administered a dose of intramuscular (IM) ketamine in a comfortable setting with eye-covering, blanket, and music to support your experience. A non-ordinary state of consciousness will ensue, when you may experience altered perceptions, revisit memories, or have introspective insights. You are in a safe, controlled environment with medical professionals to guide and monitor you.

You may experience tingling, euphoria, and a feeling of separation from the environment, your body, your problems, and your pain. Your sense of time and space may be significantly altered. You may feel yourself to be in this detached state for up to an hour after which you will be taken to a lounge where you will be provided with juice, water, or a light snack. Once the physician feels you are ready to go home, they will let your support person know that your treatment is completed.

Post-session support is a vital part of the Odyssey experience. A day or so after your treatment, you have a post-dose counselling session to review the insights and emotions that came up. Your counsellor will guide you through the key parts of your insights and help you apply your learnings to your daily life. Additionally, you’ll visit your Odyssey Online portal to receive guidance on how you can use Mind + Body Integration practices to discuss and process what you experienced.

This is the time to understand and assimilate the insights and emotions from the session, ensuring they contribute positively to your ongoing life journey. The emphasis is on taking concrete actions that resonate with the insights you gained, promoting lasting change.

Integration is the process of reflecting on and incorporating insights gained from a ketamine session into your everyday life. While ketamine boosts neuroplasticity, making lasting change requires effort and action. It’s vital to take positive steps after your session to ensure the benefits are long-lasting.

The results of ketamine are often gradual improvements, rather than sudden or dramatic changes. Patients may need a series of treatments to gain longer-lasting effects.

That being said, ketamine-assisted therapy is considered the only rapid-acting treatment for depression. For patients with mood disorder, some will begin to feel better immediately after their first therapy session and this has been seen specifically in patients experiencing suicide ideation. Others will not notice significant relief until they complete a series of treatments.

There are no known long-term side effects of receiving ketamine on a short-term basis in a medical setting.

Yes. Ketamine has many legitimate uses in medicine as an anaesthetic agent. It is also used to treat acute pain in an emergency setting. Ketamine is sometimes prescribed at low doses for severe chronic pain and is given intravenously, intramuscularly, intranasally, and sublingually for the treatment of major depressive disorder, treatment-resistant depression, and suicidality at medical clinics throughout North America and Europe. You need a referral from a GP, psychiatrist or nurse practitioner to access Ketamine in a medical clinical setting.

Ketamine was originally developed as a fast-acting dissociative anaesthetic. Ketamine-assisted therapy for treating pain and mood disorders is an “off-label” treatment, which means the medicine (ketamine) is being used to treat different conditions from the condition for which its use was originally approved. “Off-label” treatment is common practice throughout the world by medical professionals.

There is a good evidence base for using ketamine, especially in treatment-resistant depression and rapidly decreasing suicidal ideation. This medication has been used safely for many years.

When ketamine is administered in a closely monitored treatment with excellent medical and psychological oversight, the risk is low. However, in an uncontrolled recreational setting, there is a risk of addiction.

Yes. Treatment requires a referral from your family doctor, GP, pain specialist, nurse practitioner or psychiatrist.

Clinical trials for KAT have shown positive results in over 70% of patients with treatment-resistant depression.

Some patients can achieve long-term relief after one treatment of KAT. Others find that ongoing therapy enhances the effects of psychotherapy, lifestyle changes, and/or pharmaceutical drugs such as antidepressants. Follow-up or ‘booster’ ketamine-assisted therapy sessions can be provided on an as-needed basis for maintenance.

You do not need to arrive with someone else or have someone else present during your treatment. However, you must select a designated person to take you home after your appointment and that the medical staff can be in contact with for 24 hours following your treatment. We advise that your designated person supports you by creating a safe, non-intrusive, and comfortable environment when you get home. Your designated person will be educated regarding your treatment and be provided with contact information for medical staff.

We advise against operating machinery or a motor vehicle until the following day.

A history of schizophrenia, alcohol use disorder, or any other addictions are currently exclusions. Please contact us to discuss further.

You will need to let us know about any medications you are currently taking, in particular:

  • Lamotrigine, (Lamictal), Benzodiazepines, including Xanax (Alprazolam), Ativan (Lorazepam), Valium (Diazepam), and Klonopin (Clonazepam): these decrease the effects of ketamine and may need to be stopped a few days prior and after the treatment.

  • Antidepressants (SSRIs/SNRIs): you may continue taking these during treatments.

At the Ketamine Suite intramuscular ketamine is injected to induce a psychedelic experience that typically lasts about an hour. Ketamine leaves the body fairly quickly and has a half-life of one to three hours, meaning you can expect to go back to your normal activities the next day.

Intravenous ketamine is ideal for anesthesia because it is 100% bioavailable, meaning it is completely absorbed and used in the body. IV ketamine can also be infused slowly over 40 minutes to induce a psychedelic experience that can be beneficial for the treatment of depression and chronic pain.

Intramuscular ketamine is 75 – 93% bioavailable onset of the experience occurs within 2 to 5 minutes and lasts for about an hour.

You will typically return to a normal state of consciousness within an hour and half but it may take several hours for ketamine to completely leave your body. It is recommended that you return home to a calm environment to rest for the remainder of the day.

No. Our doctors cannot provide a prescription for any ketamine that is not used within the confines of our program.

Yes, your doctor does need to fill this out. Referrals are required in BC, and it also helps to keep your doctor “in the loop” with your healthcare.

KAT is more successful when performed within a therapeutic context, and integration strategies are important to the healing process.

Our ketamine-assisted therapy includes a comprehensive aftercare program including a detailed list of lifestyle changes and integration strategies to help support your recovery. Ongoing questions and concerns can be directed to the psychotherapist by appointment.