I had the great honor of interviewing my ketamine doctor, Dr. Glen Brooks. I’ve included the summary and transcript of that conversation here. You can see the episode itself on YouTube.
(Keep scrolling for the video version of this post.)
Introduction
Dr. Glen Brooks of New York Ketamine Infusions—with locations in New York City; Madrid, Spain; several other locations; and www.NYketamine.com—is the only doctor I can recommend going to if you’re interested in checking out ketamine for post-traumatic stress (PTS/PTSD)1 or pain. I don’t get the infusions for pain; I get them for PTS from repeat rape and extreme childhood traumas.
One of the reasons that I wanted to interview him was to let people know that ketamine is an option if they’re suffering from post-traumatic stress. And, just as importantly, to let them know that ketamine is extremely safe and not addictive at all, when administered properly by a trained clinician such as Dr. Brooks.
In the episode, and transcript below, we cover some of the common objections that the general public have about ketamine. We also cover Dr. Brooks’ protocol, which is very different from any clinic out there that I’ve looked into. Or at least it was as of several years ago.
When you’re doing your own research, please refer to the episode or transcript to ask the kinds of questions that you should be asking when you’re considering which clinician or doctor to select to give ketamine a try.
If you feel that ketamine is an option for you, or something that you’d like to explore to help alleviate PTS, get treated by Dr. Brooks if possible. He’s literally helped save thousands of lives, including my own. In 2016, I was on the verge of suicide. I would’ve gone through with killing myself if I hadn’t found Dr. Brooks.
Please help me pass on this information. Share it with your friends. Recommend the episode or transcript in order to educate the general public. This medicine might be the key to saving your friend, colleague, or child’s life. Thank you.
Interview / Episode Summary
Dr. Glen Brooks explains, based on decades of ketamine research, why post-traumatic stress (PTS/PTSD)1 isn’t a chemical imbalance and is really much more of a structural problem. He explains how ketamine can treat the neurons in our mood centers so that we PTS sufferers can have a normal mood again.
Ketamine is a very good drug and it’s a very safe drug. Dr. Brooks’ success rate is eighty-five percent to ninety percent for someone under age thirty. Between ages thirty and fifty, the success rate is eighty percent. For over fifty, the success rate is worth giving ketamine a try if nothing else has worked for you.
Unfortunately there’s a lot of material about ketamine that frightens patients and frightens the parents of young adults who should be getting treated. There’s the argument that ketamine is a recreational and addictive drug and that we don’t know the long-term consequences of using ketamine. That’s incorrect. We do know. It’s a proven science.
No addiction comes from any of the clinics that administer ketamine properly. There’s absolutely no dependence on this drug at all.
If you’re at the end of your rope, call Dr. Brooks to see if you’re a candidate for ketamine treatment. He literally saved my life and . . .
. . . has treated more patients than the next five or six, or maybe seven or eight clinics, put together. This medicine might be the answer for you, too.
Transcript of Dr. Brooks’ Interview / Episode
Torah Bontrager: Hi Everyone, I’m here today with my ketamine doctor, Dr. Glen Brooks, and he’s going to explain what ketamine is and how it helps people with PTSD,1 chronic pain, and depression.
Thanks for being here. I really appreciate your. . . .
Dr. Glen Brooks: Thank you.
TB: Maybe you could help us understand what exactly ketamine is and what it does for people with PTSD in particular.
GB: Ketamine’s a pretty interesting drug that’s been with us since the sixties. It gets a lot of funky press. If you read most of the media articles, you’ll think it’s nothing but a club drug or a horse tranquilizer. But in fact, for the past fifty years, it’s been a very important human general anesthetic agent.
It was first used in Vietnam in the sixties. In the 1970s, it was in pretty much every civilian hospital throughout the country, and it spread throughout the world.
I’m an anesthesiologist and I’ve been [administering] ketamine since 1974. It really has wide applications. It’s used in operating rooms, emergency rooms, intensive care units, burn units, pain centers, radiation therapy, pediatric anesthesia, general anesthesia. . . . It’s the only drug that Doctors Without Borders has.
TB: Oh, really, they use it?
GB: It’s the only general anesthetic agent they have. And it’s on the World Health Organization’s list of top ten essential drugs. So it’s far more than just a club drug or an animal tranquilizer.
But the discovery that ketamine was very useful in treating post-traumatic stress actually began in the early nineties during the first Gulf War.
That original paper was published by the doctors at Walter Reed and serious research began at Yale in 1995. Here, the National Institutes of Mental Health and pretty much every major medical center over the past twenty-five years or so has been involved in some kind of ketamine research. Right here in New York City, we saw some very large programs at Mount Sinai and Columbia University [Torah’s alma mater].
What I treat for the most part is post-traumatic stress disorder. But it’s not veterans returning from war; it’s survivors of childhood traumas. When you say childhood traumas, people generally go right to physical and sexual abuse, which is true for many of my patients. But psychological traumas can be just as devastating.
Traumas at home. Parents who are either alcoholic or some other substance abusers, divorce, abandonment, insecurities that come because of those, fighting parents, problems at school, body dysmorphias that some patients experience during their adolescent teen years. Bullying can be quite devastating as well.
There are many causes of childhood stress. To understand the implications of childhood stress, we have to understand somewhat mood center development.
We have three important mood centers: (1) our prefrontal cortex, (2) amygdala, and (3) hippocampus.
Most of their development takes place between the ages of two and eighteen. That development is very much dependent on the substance called bdnf, the brain-derived neurotrophic factor. That’s the substance that’s responsible for the development, maturation, and maintenance that then writes the synapses that allow the neurons in our mood centers to communicate with each other. We need that kind of intact connectivity to have normal mood.
Now childhood stress, for whatever reason, raises brain cortisol levels. During those developmental years, when you raise brain cortisol levels, you end up suppressing the production of the brain-derived neurotrophic factor. So our mood centers never really develop.
TB: Right. So is that actually a brain injury as opposed to a mental illness? Or what’s the difference?
GB: It’s not really a brain injury. It really has more to do with maturation, mood center maturation rather than brain injury. But if your mood centers don’t mature during those adolescent teen years, you are very prone then to lifelong problems that involve the symptoms of post-traumatic stress. Many of my patients begin to crash right after high school, the first year in college, or whatever they’re going into.
Now the symptoms of post-traumatic stress disorder vary from patient to patient. Among the patients that I see, depression and anxiety are the two most common, closely followed by obsessive compulsive disorders. Not necessarily ritualistic behaviors, but constant ruminating negative self-deprecating thoughts that often spiral toward suicide ideation. In other patients, it’s eating disorders and for some, it’s raging anger.
So there’s a whole buffet of different symptoms that go along with post-traumatic stress disorder.
Now for the past fifty years, psychiatrists have been treating the symptoms of post-traumatic stress as if each represented some sort of a chemical imbalance. So that’s why they prescribe drugs that increase serotonin or dopamine or norepinephrine or lithium or acetylcholine or gaba.
Well, what the ketamine research has been saying for the past few decades is that it’s really not a chemical imbalance. That’s why most patients really don’t respond to these medications. It’s really much more of a structural problem.
If you did a biopsy of the neurons in the prefrontal cortex, and looked at them under the microscope, it would be “Oh, my God, how could this lovely young woman possibly have a normal mood when there’s such a dearth of the synaptic connectivity that she would need to have for a normal mood.”
So what ketamine does different from other medications is that ketamine turns back on brain-derived neurotrophic factor and starts regrowth. Starts to grow those synapses that have been missing. And that’s really the science behind ketamine.
TB: Wow, that’s awesome! What are the most common objections to administering ketamine for PTS?
GB: Well, again we get back to some of the media articles that are quite commonly read. There’s a lot of material that just isn’t true. And unfortunately there’s a lot of material in these articles that frightens patients and frightens the parents of young adults who should be coming in for treatment. Again, the arguments are always that it’s unproven science, that it’s really an animal tranquilizer.
People don’t understand the important role that ketamine has played for the last five decades in every hospital throughout the world. People talk about problems with addiction. We don’t see addiction in this clinic. We don’t see addiction in any of the clinics that administer ketamine properly. There’s absolutely no dependence on this drug at all.
And then there’s always the argument that it’s quite popular [as a recreational drug] and that we don’t know the long-term consequences of using ketamine. Well, we do. This drug has been around for fifty years and it’s been used in much larger doses than we use to treat post-traumatic stress.
Patients in pain clinics get doses forty to fifty times higher than any dose we use here [for PTS patients] and they do it for years in some cases, with absolutely no signs of any organ toxicity.
So the claims really aren’t based on reality.
TB: How many patients have you treated?
GB: We’ve treated over fifteen hundred patients in over the past five years.
TB: Yeah, that’s definitely long enough to know whether it’s actually a bad drug or not.
GB: It’s a very good drug and it’s a very safe drug. Ketamine has an amazing safety profile. And even after fifty years of use in hospitals, ketamine’s still considered to be one of the safest general anesthetic agents we have. And reserved for some of the [unintelligible] patients that come in to operate. So ketamine safety really isn’t a concern.
TB: How would you determine who would be a good fit for ketamine if they’re suffering from post-traumatic stress?
GB: There are three things I consider when I first talk to a patient over the phone. The first is a story. I need to hear that there’s a childhood piece. That on some level this patient had a pretty traumatic childhood. That’s probably the most important, because that tells me that there’s a good chance that mood center development was interrupted. Or stymied to some degree. That gives ketamine something to fix.
The second is age. Patients under thirty do much better than patients over seventy. So age is another important consideration. We do see improvements in patients over seventy, but it’s much less predictable.
If I get somebody in under thirty, we’re looking, in our experience, at eighty-five percent to ninety percent success rate. And between ages thirty and fifty, it’s still solidly eighty percent.
TB: Oh, wow, that’s a big percentage, all things considered.
GB: Between ages fifty and seventy, it drops off. But it could be two out of three patients. So it’s certainly worth considering.
The third factor seems to be sex. There have only been . . .
. . . a couple of research papers, but it looks like estrogen does give women a bit of an edge over guys. Here in our patient population, it’s pretty much 50-50. I think the women do slightly better.
TB: What factor does estrogen play?
GB: I have no idea.
TB: How is your protocol different from other clinics? When I first looked into it, some clinics wanted me to pay for six sessions up front. Without even knowing whether it would help me. How are you different?
GB: Our clinic’s a little bit different because it’s really based on experience. We’ve probably treated more patients than the next five or six, or maybe seven or eight clinics, put together.
TB: Wow.
GB: Through experience, we have a pretty good idea who’s going to respond and who’s not. So the first thing is patient selection. I’m pretty honest with patients. If I think I can help them, I’ll tell them. If I think I can’t, I’ll tell them I can’t. But no patient population is one hundred percent in terms of efficacy.
So what we generally do is that we start with two infusions. For patients over fifty, I might push them to a third infusion before we decide it’s not working. If I don’t see results in younger patients after the first two infusions, and older patients after three infusions, we stop.
We schedule those generally every other day. If patients do respond, then we complete a full series, which empirically seems to be six infusions. And we can do them as close as six infusions in six days, which is what we do for international patients and patients who come from far away and [have to] stay in expensive hotels here in New York City.
Or we can spread that over about two weeks. But I don’t like to go any longer than that because each infusion builds on the one before in terms of encouraging synaptic growth. Large gaps between infusions can interfere with that.
TB: Awesome. Thank you so much!
Watch the Video
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To education,
Torah
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