Mindbloom Review

Our Mindbloom review is brought to you by James Dixon, one of our leading mental wellness writers here at SOMA Analytics. He puts this telehealth company to the test and speaks to users of the service to determine just how good it is.

We are seeing an explosion in online telehealth companies seeking to use cutting edge communication technology to remotely connect patients with healthcare teams. It makes a great deal of sense. Even traditional therapists and the like have shifted a lot of their workload online, seeing patients via video calls and Facetime, especially since the coronavirus pandemic put paid to in-person consultations for a couple of years.

We’re also seeing a rise in psychedelics as legitimate treatment forms for certain mental health conditions, such as depression and anxiety. Research is ongoing into their effects, though a lot of the data so far looks incredibly promising.

Mindbloom seeks to combine these two innovations. They are a telehealth company, an online platform, designed to connect users with doctors who are licensed to prescribe ketamine to treat depression and anxiety. They seek to spearhead the next move into psychedelics for everyday use, promising breakthroughs to their patients through guided ketamine experiences.

You wouldn’t be alone if you thought this all sounded a little sketchy. Online doctors prescribing ketamine to a vulnerable section of the population?

Definitely off-sounding.

However, if it’s done well, this kind of thing can truly be life changing (in a good way!)

The question is whether or not Mindbloom do it well – do they conduct due diligence; do they put their patients first, treating them like patients rather than consumers; are they safe and responsible; and do they track their clients’ progress and keep tabs on their wellbeing?

About Mindbloom

Mindbloom’s treatment plans revolve around ketamine use for depression and anxiety. This is actually quite sensible in theory – there is a robust body of data supporting its use.

Ketamine is a little different from how you might picture psychedelics. It’s different from well-known psychedelics like psilocybin and LSD.

Rather than working on serotonin receptors in the brain, as these latter drugs do, ketamine interacts with NMDA receptors. These involve the neurotransmitter glutamate. Its effects on glutamate can include dissociative feelings, euphoria, and only sometimes hallucinations. I’ve used it in the past and experienced only mild hallucinations, with the euphoria being far more notable.

In higher doses, ketamine is also often used as an anesthetic or tranquilizer, particularly in veterinary surgery.

Early data for ketamine use as a treatment for anxiety and depression are very promising. It’s been shown that some people, for instance those with drug-resistant disorders like major depressive disorder, can see rapid, considerable improvements in their symptoms. These can even often be seen after just a session or two.

Ketamine In Modern Medicine

However, ketamine is still being analyzed with specificity in mind. Certain groups can benefit from it. But can everyone? And is it appropriate as a first port of call? Rather, many experts warn that it should be sort of a treatment of last resort, after more conventional options have been explored and exhausted.

We also need to know the shape of ketamine use in treatment: does it work by itself, is it better paired with psychotherapy, should it be used at home or in controlled settings? Indeed, should users be supervised during ketamine use, as is common with other psychedelic treatments (think magic mushrooms)?

These questions are kind of ignored by broad swathes of the medical and pseudo-medical communities. If we’re being cynical, this is true particularly where there is a quick buck to be made, as there is for companies like Mindbloom.

Ketamine is at present the only psychedelic medicine that companies can legally open clinics for. It is the only psychedelic medicine that telehealth companies can legally prescribe. Because of this, there is an intense focus on ketamine, with the number of US clinics offering it as a treatment jumping more than five-fold between 2015 and 2018.

However, a 2018 investigation found that many of these new clinics made sweeping claims about their products whilst ignoring some of the really quite major side effects that can accompany them.

Screening processes were minimal. As we will see, they are with Mindbloom.

Realistically, if you fancy a ready source of ketamine, you can fake it pretty easily during your consultations and get it over the counter without difficulty. Clinics were found to offer inconsistent dosing, including amounts and frequency. Few were adhering to the American Psychiatric Association consensus statement for ketamine therapy – unfortunately, this includes Mindbloom.

This is a real shame. As above, there is a growing body of evidence that ketamine could be a real asset in treating common mental health concerns if administered correctly and safely.

Ketamine’s Efficacy For Depression & Anxiety

Ketamine has been found to be potentially more effective in treating depression than common pharmaceutical antidepressants. Per a study published in The American Journal of Psychiatry, a single infusion or dose of ketamine can be more effective, with sustained dosing, in this case three doses over a fortnight’s course, giving added benefit.

In fact, 59% of depression patients reported a symptom reduction greater than 50% after their ketamine infusions.

This is in line with a 2020 meta-study that looked at an array of clinical trials of ketamine therapy and depression. Ketamine therapy was found to be effective across the board at reducing average depression scores. It was found to be particularly effective for patients with a history of unresponsiveness to pharmaceutical antidepressants.

Then there are the promising effects that ketamine can have on anxiety symptoms. It’s been well documented that it can have a very positive effect on patients suffering with common anxiety disorders. A clinical trial from 2020 looked into its benefits for patients with treatment-resistant anxiety disorders – i.e., anxiety disorders that don’t respond to conventional pharmaceutical medication.

Ketamine therapy was shown to be far more effective for anxiety than a placebo. Reductions in anxiety lasted for up to a week after a single infusion.

These kinds of results have been repeated elsewhere. In one study, patients suffering with treatment resistant anxiety or social anxiety disorder (SAD) were given weekly ketamine infusions for twelve weeks. A full 90% of participants reported ‘marked improvements in functionality and in their personal lives’, according to the study’s authors. These included notable reductions in their anxiety levels.

So there is a strong body of evidence showing ketamine’s potential as a treatment for anxiety and depression. This seems to be particularly the case for depression, where the data seem more solid. However, this all tends to pertain to those suffering with treatment resistant forms, or those who are themselves treatment resistant.

These studies were all also conducted under controlled conditions in a safe clinical environment. This is all a far cry from being able to say that Mindbloom’s brand of treatment is safe and effective. Telehealth services may well safely, effectively branch into ketamine treatment one day, but I’m skeptical that Mindbloom have managed it here.

Using Mindbloom

At first glance, Mindbloom seems to be a pretty decent for a telehealth service. You go through an initial online screening, after which you will be connected with a qualified nurse practitioner who runs through your medical history. So far, so good. These seem like good first steps.

Then this nurse practitioner decides on a dose. This seems… abrupt. It’s a low threshold to get over to then be talking doses. This strikes me as irresponsibly fast, almost like they have a vested interest in getting you onto a treatment plan (which of course they do – you’re paying for it, after all).

You choose a ‘guide’, which seems sensible. This is someone who will mentor you, check in with you either side of each ketamine session. However, these sessions are conducted at home. The check ins are virtual. The guides aren’t necessarily qualified. Again, the theory is good. The practice could be described as reckless.

There are also options to join group ‘integration’ circles, in which you can talk about your experiences and share tips and tricks, and so on. These seem pretty decent. However, I would suggest that given the nature of the treatment, one to one integration is far more appropriate.

Mindbloom offers this, but charges an eye watering $1,158 for six sessions. This is billed in three lots of $386 and doesn’t cover any other costs. Mindbloom doesn’t take insurance, so you will need this in ready cash out of your own pocket.

I managed to reach out to some former patients who shared their experiences with me.

A typical treatment plan can begin with a couple of sessions in which doses are raised quite quickly. One former patient shared that they began with 200 mg in their first session, before coming up to 400 mg in their next. The results were underwhelming, with a little mellowness and nothing much else.

They also shared that their guide conversations were pretty lackluster. They would reply to every comment by saying ‘thank you for sharing that with me’, offering nothing of use in return. The guide went AWOL after the second session, telling the former patient that they could go self-guided from there on out.

The former patient raised their dose to 600 mg. Their following experience was too much. Mindbloom signed off on this rise and sent out the ketamine pills, which led to vivid, overwhelming dissociation. When they later checked the packaging, the patient saw that they had been sent the wrong dose. They had been told to take three 200 mg tablets. Instead, they were sent three 300 mg tablets, giving them a total of 900 mg for their third ever session.

The guide was no help. There was no response, then the former patient got in touch with the company. Mindbloom assigned them a new guide, who promptly left the company after ghosting the former patient.

This isn’t a unique story. Other former patients shared similar testimonies, including plenty of organizational difficulties within Mindbloom itself, long waiting times for any interaction, a generally pervading deficit in any kind of therapeutic support or consistency, and even dishonesty about medical experts’ affiliation with the company.

Mindbloom has been accused of similar issues by other publications, to which they seem only to issue the same block text response:

Mindbloom is on a mission to transform lives by expanding patient access to safe, clinically effective, and science-backed mental healthcare therapies. Mindbloom’s platform has grown significantly since launch to meet growing demand for alternatives to traditional prescription drugs in the face of a mental health crisis. Each day, our team works tirelessly to meet our clients’ and providers’ needs, and to improve our services. We are grateful for the guidance of leaders in the fields of psychiatry and psychedelic medicine who have developed and oversee industry-leading treatment protocols, including our Medical Director Dr. Leonardo Vando, our Science Director Dr. Casey Paleos, and our world-class board of clinical advisors. We are proud of the clinical outcomes, safety record, and transformational stories we’ve accumulated across thousands of clients, exceeding those of traditional treatment options such as SSRI antidepressants. We remain committed to bringing positive change to the lives of our clients and being a supportive ally throughout their journeys.

There are plenty of clinicians, researchers, and academics whose work revolves around ketamine who have expressed shock at Mindbloom’s operation. Not the theory itself – again, what they are attempting could one day be done well.

Rather, in the medical supervision and therapeutic deficits, alongside the speed with which Mindbloom have jumped into ketamine treatments. Efficacy and safety of treatments is still up in the air.

Until we learn more, ketamine should be treated very tentatively and under ongoing expert supervision. It certainly shouldn’t be rolled out through a hands-off telehealth company who seem only to wear a veneer of clinical respectability.

They are also costly and pretty inaccessible for most. I would usually cite a lack of accessibility as a real concern. I would usually cite low cost and ease of accessibility as a great thing. I can’t celebrate it here, however. The more people who can’t access Mindbloom, the better, but actually the base package is accessible to most.

Ketamine isn’t generally covered by medical insurance. This is part of why Mindbloom appeals to its customer base – it’s less than $100 per month if you’re happy with almost no therapeutic oversight of any worth. As above, it’s far costlier to maintain contact with a one-to-one specialist. But it is cheap to actually chat to a nurse and have ketamine sent out to you.

This is the real issue. Low monetary cost and broad accessibility come at a far greater real-life cost. Proper support, care, and oversight have been sacrificed to keep prices down. And we are talking about vulnerable people, here, people whose experiences of depression and/or anxiety have driven them to the point that they are willing to buy into telehealth ketamine.

These are not people who need their lives made harder by a lack of communication, or who need their health and wellbeing risked by unprofessional, unreachable, spuriously qualified ‘guides’, or who need their medication routine interfered with based on a very cursory glance by a nurse.

There are also some pretty major side effects to take into account when dealing with ketamine (hence the lack of oversight and engagement being so egregious). It is, after all, a hallucinogenic drug. Please, please never forget this. Common side effects are psychiatric rather than anything physical. In a population taking it to overcome psychiatric concerns, this is quite alarming.

Again, this is why proper oversight is needed.

A medical review from 2019 looked at ketamine use for depression. It found that 38% of studies described acute psychiatric side effects. 72% of the studies it looked at made mention of serious dissociative side effects. The cure may well be more damaging than the illness, then.

There are a couple of minor physical side effects to bear in mind with ketamine use, too. Heart rate and blood pressure can both spike. You may also experience headache, disorientation, nausea, and/or dizziness.

The short term effects of ketamine have been well-studied. Side effects are well-documented. This isn’t true of the long term effects, however, where data are lacking. Until longer term data are collected, there is no way of knowing the lasting effects ketamine might have. Until this point, there will be no way to safely use it as a standalone antidepressant or anxiety cure.

Mindbloom Pricing

As above, Mindbloom’s basic services are cheap – worryingly so, in fact, as they have cut corners to keep accessibility high. They don’t accept insurance, though some of the costs you will incur with them can be reimbursed by some insurers. They have a decent pricing page that will give you all the codes you need to provide your insurer with.

The initial cost is $1,158. I know this may not sound cheap, but for healthcare, it really is. You get six ketamine treatments for this, which would elsewhere fetch around $300 a go, so $1800 all told.

Alongside this, you get two psychiatric clinician consultations and unlimited messaging. If the two psychiatric clinician consultations were good and Mindbloom responded to your messaging, this really would represent good value. Often, however, the consultations are shallow and your messages will go unanswered.

You can renew your prescription for $768 thereafter. This price includes a psychiatric clinician consultation, unlimited messaging, and another block of six ketamine treatments. Again, on face value, this is reasonable. Given the shoddy customer care, though, it begins to look more like money for nothing.

Verdict

As I keep saying, ketamine seems workable as a treatment for depression and anxiety. The data are certainly very promising, even if longer term consequences are at present a bit of an unknown. Telehealth is certainly often a good idea and can be used to great effect, making elements of healthcare far more affordable and accessible.

There may even come a time when ketamine therapy and telehealth can be put together well. A hybrid model could definitely work – distance monitoring and prescription coupled with in-person dosing and some consultations.

That time isn’t quite here yet. It definitely isn’t here as Mindbloom set it out. This is a bad product, dangerously formed, poorly administered. I really cannot recommend highly enough the virtue of running from it as fast as you can.

If you are struggling with anxiety and/or depression, speak to your healthcare provider and exhaust every option going before turning to newer developments like ketamine therapy. And if you eventually want ketamine therapy, source it from elsewhere. Don’t go near Mindbloom.