Shroom Shmooz
In this edition, we begin a series of spotlights on psychedelic therapies. We start with ketamine, the first legalized psychoactive drug approved for the treatment of a mental health disorder—treatment-resistant depression (TRD)—being marketed under the brand name Spravato®. ‘Friends’ actor Matthew Perry’s untimely death last October has introduced ketamine to a broader market in an unfortunate way. While this may bring home a stark warning about the dangers of unsupervised at-home ketamine treatment, it should not detract from the value of the properly supervised use of ketamine in the treatment of mental health disorders. Ketamine in supervised and monitored clinical settings is administered in low doses, lending itself to low dependence potential. Ketamine is currently the only FDA-approved drug with psychoactive properties available to treat such disorders. Ketamine, originally developed as an intravenous anesthetic in the 1960s, is considered an atypical psychedelic given its capacity to cause a transitory modification in consciousness known as disassociation. Whereas typical psychedelics like psilocybin work by overriding the brain’s inhibitory architecture by activating the serotonin receptor, ketamine works by relaxing it as an antagonist of the glutamate-based N-methyl-D-aspartate (NMDA) receptor, the primary excitatory neurotransmitter in the human brain. Studies have shown that 50-80% of patients receiving ketamine therapy measurably reduced systems of depression within 24 hours of receiving their first treatment. Despite being an expensive therapy with limited payor coverage, particularly for medical off-label use, there has nevertheless been strong demand for ketamine therapies as evidenced by JNJ’s reported Spravato revenue, the proliferation of ketamine clinics in the US, and the increased trend in ketamine prescriptions. In the publicly traded investment space, the major ketamine players are Johnson & Johnson (NYSE: JNJ), Awakn Life Sciences (NEO: AWKN), Seelos Therapeutics (NASDAQ: SEEL) among the drug developers, and Numinus (TSX: NUMI) and Irwin Naturals (CSE: IWIN) among the clinic networks.
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