Advocating for Patients with Treatment Resistant Depression, PTSD, and Anxiety

This article first appeared in the Fall 2021 issue of MetroDoctors magazine, a publication of the Twin Cities Medical Society

The health and social upheaval caused by the pandemic has only exacerbated the mental health crisis and those who work in healthcare find themselves overwhelmed with more severe cases. That’s why a new Minneapolis ketamine and TMS clinic, Advanced Brain + Body Clinic (AB+BC), opened recently, specializing in severe depression, anxiety, and PTSD. 

Through the pandemic, we’ve seen less equitable access to healthcare treatments as lower income brackets were hit hardest with job losses. Working with patients and insurance providers alike, AB+BC’s goal is to make treatments accessible to all. 

AB+BC’s founding psychiatrists Dr. Stephen Manlove and Dr. Brian Johns have been long-time advocates and early adopters of the latest evidenced-based modalities, including ketamine and TMS to treat symptoms of depression, anxiety and PTSD.

Making TMS Accessible

As a pioneer in using transcranial magnetic stimulation (TMS) for the treatment of major depressive disorder, Dr. Manlove was instrumental in getting insurance companies to start covering this highly effective treatment. TMS therapy was FDA approved in 2008.  

TMS is a noninvasive, outpatient procedure using repetitive, pulsed magnetic fields similar to those in an MRI to stimulate the executive functioning center of the brain. This helps the brain transition out of the default mode network to stop repetitive, negative thoughts and improve symptoms of depression.

TMS is a noninvasive, outpatient procedure using repetitive, pulsed magnetic fields similar to those in an MRI to . . . stop repetitive, negative thoughts and improve symptoms of depression.

Dr. Brian Johns, ketamine and TMS doctor MN Dr. Steven Manlove, MD, Psychiatrist and TMS and ketamine doctor MN

Advancing the Use of Ketamine for Depression

Because suicide is the 2nd leading cause of death among people aged 10-34 in the U.S., medical professionals need to bring suicidal thoughts under control quickly. Luckily, powerful treatment options are now available.

Dr. Johns performed the first study with a team of researchers at the Minneapolis VA to add a low-dose of ketamine, an anesthetic agent FDA approved in 1970, to outpatient regimens in patients whose symptoms of depression didn’t respond to numerous other medications or electroconvulsive therapy (ECT).  After 92% of patients improved with only two weeks of treatment, Dr. Johns opened one of the first clinics in the region for treatment resistant depression (TRD) to offer ketamine covered by insurers. 

Soon after, Dr. Johns consulted with Jansen Pharmaceuticals in the development of Spravato (esketamine), which was FDA approved to treat depression in 2019, and suicidal thoughts in 2020.  

People with depression who have failed four or more medications have less than a 10% chance of improving with another medication trial. These same people have a 70% chance of responding to ketamine, Spravato or TMS . . .

Both ketamine and esketamine treatment work differently from any other depression medication. They cause rapid neuronal growth within hours of administration, resulting in immediate relief for some patients. 

AB+BC is the only independent clinic in the region that works with insurers to offer all four routes of ketamine administration plus Spravato and brain stimulation to make these resources more widely available. By offering all four routes of administration, we can tailor your treatment method to your exact needs and personal preferences. For example, if you need a stronger dosage, receiving ketamine through a shot will provide a higher concentration of the medication. On the other hand, if you hate getting shots, taking oral ketamine may be preferable.

The response to these services has been so overwhelming, that the clinic has doubled in size in its first three months.

According to the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) study, people with depression who have failed four or more medications have less than a 10% chance of improving with another medication trial. These same people have a 70% chance of responding to ketamine, Spravato or TMS. That’s why the team at AB+BC advocates for innovative treatment options to help provide better outcomes.

As part of this work, Dr. Manlove hosts a New Paradigms conference each year to spread awareness about depression, anxiety and PTSD. Also covered at these conferences are the many new options that exist for patients who need the strongest antidepressants available. 

Educating & Partnering with Physicians and Mental Health Providers 

You will see Dr. Manlove and Dr. Johns presenting in educational seminars and Lunch & Learn sessions on mental health in the Twin Cities area. Their goal is to spread awareness of these highly effective alternatives to antidepressants. Additionally, they continue to advocate for insurance coverage to make these treatments affordable for all.   

Give us a call to learn how we can partner with you to help your patients. Or, schedule a Lunch & Learn session at your office by contacting Candi Tucker at candi@advancedbrainbody.com.