Big Pharma Hates This 1 Trick to Inject Psychedelics At Home
Six years ago, when I told people for my 3rd startup I was going to build an iconic mental health brand that provided at-home psychedelic medicine, the most common reply I got was, “you’re crazy, Dylan” (the irony wasn’t lost on me).
I don’t blame them.
All but one psychedelic medicine was illegal.
Ketamine was demonized as a horse tranquilizer or Special K.
Nobody was asking for ketamine therapy — treatment was expensive, not widely available, and involved tripping in a clinic.
What was heretical then seems obvious now.
“Some of the best ideas look heretical at the time. When people claim that they can do something that is indistinguishable from magic, for example, they might be labeled a witch back in the day. When you make a technological advancement it is indistinguishable from what looks like witchcraft sometimes.” — Mindbloom early investor Cyan Banister on The Tim Ferriss Show.
Since then, Mindbloom has facilitated 600,000 at-home ketamine therapy sessions at 1/5 the cost of in-clinic IV ketamine, and published two peer-reviewed studies showing that Mindbloom works better, faster, and safer than legacy treatments like SSRIs, benzos, and talk therapy.
During that time, a slew of fast-followers have come and gone trying to copy our brand, clinical protocols, and product (which I celebrate as a sign of success — it’s much lamer if nobody cares enough to copy you, poach your team, or write hit pieces about you).
Still, there’s a flaw in our model that’s eaten at me since Day 1: Mindbloom only gives clients the second best form of ketamine, sublingual tablets.
That ends today, as we’re launching Mindbloom Injectables — the largest leap forward in mental healthcare since Mindbloom launched at-home ketamine therapy in 2020.
Injectables are the best experience that ketamine therapy has to offer. This is the ketamine therapy our clinical leaders and I have wanted to provide from Day 1.
So why hasn’t Mindbloom offered injectables this whole time? And why did the mainstream media start attacking us before it even launched?
It’s the same reason that ketamine and other psychedelics aren’t viewed as first-line mental health treatments.
The system is broken, and healthcare decisions are driven by greed and bad incentives.
Mental health care isn’t broken by accident — it’s broken by design.
To understand how we got here — and why we didn’t get here faster — let’s start with the pre-ketamine status quo.
For the last 35 years, the first-line treatment for depression has been selective serotonin reuptake inhibitors (SSRIs) like Prozac and Lexapro. The basic model is:
Feel depressed
Go to Primary Care Physician or Psychiatrist
Get prescribed SSRI
Wait 6-8 weeks to see if it works
Rinse and repeat until you find one that works
Over half of people won’t find one that works
The rest take the SSRI for the rest of their life while taking other medications to treat the side effects
Today, 47 million Americans are taking SSRIs and similar antidepressants. With that breathtaking level of use, you’d think SSRIs must work pretty well, right?
You’d be wrong.
SSRIs are no more effective than placebos.
And it gets worse: the “chemical imbalance in the brain” theory underlying SSRIs has been completely debunked.
"The main areas of serotonin research provide no consistent evidence of there being an association between serotonin and depression, and no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations." — Nature, 2022.
The truth:
SSRIs have low response rates — fewer than half of patients see improvement.
Nearly 50% of people experience brutal side effects like insomnia, weight gain, sexual dysfunction, and suicidality — which don’t always resolve after stopping
This isn’t even new information — 12 years ago, experts called to rename “antidepressants” because their negative side effects like decreased sex drive were more impactful than the purported (and largely absent) antidepressant effects.
So why are SSRIs still so widely prescribed?
Because Big Pharma doesn’t actually want you to get better. They want you to stay sick and take pills every day for the rest of your life.
Big Pharma makes $20 billion per year by keeping people on daily antidepressant pills, not even including all the other downstream health issues like obesity and heart disease strongly correlated with depression they make money off of. And Americans foot the bill — not just at the pharmacy counter, but through tax dollars funding Medicare, Medicaid, and the premiums we pay to private insurance to cover these ineffective treatments.
That’s why they spend billions every year to advertise their drugs, incentivize doctors to prescribe them, fund bad science to put lipstick on a pig, and manipulate the media and FDA to protect their cash cow.
Gold Standard or Old Standard?
So what happens when an innovation disrupts the status quo?
Does the healthcare system rally around the new, better treatment and figure out how to maximize patient access and outcomes?
Let’s use ketamine as a case study:
Ketamine was approved by the FDA in 1970 as an anesthetic. It was (and still is) administered through an IV during a medical procedure to keep the patient sedated and anesthetized.
In 2000, the first randomized controlled trial was published demonstrating that ketamine is an incredibly effective and fast-acting antidepressant. This use of ketamine is fundamentally different: you want the patient awake and aware, so you only provide 5-20% the dose of anesthetic ketamine.
The discovery of ketamine’s antidepressant effects was hailed as a stunning breakthrough.
But was there any research done to find the best way to deliver ketamine as a mental health treatment?
Nope!
The standard for ketamine therapy became IV administration in a clinic, usually administered by an anesthesiologist, because that’s how ketamine was used in surgical settings. It was pure cargo culting.
I’ve been shocked to see a majority of ketamine practitioners providing IV ketamine.
In-clinic IV ketamine is a dumb model:
It’s uncomfortable to have a psychedelic experience in a sterile clinic with a needle in your arm
It’s less effective than at-home treatment because being in a comfortable, familiar setting is clinically shown to improve outcomes
It’s inconvenient to have someone drive you to and from a clinic and spend hours in the clinic
It’s expensive because you pay for their clinical overhead
It’s inaccessible if you aren’t lucky enough to live near a clinic
But there is one group who loves this model: IV ketamine clinics. Before Mindbloom, they got to charge upwards of $1,000 per session because they know their medicine works and there was no competition.
So far, this is just a story of an incompetent system not having the right incentives to leverage a miracle drug. After all, Hanlon’s Razor says you shouldn’t ascribe to malice what can be explained by stupidity, right?
Well, providers aren’t the only ones adapting to the new reality where ketamine offers a 10X better treatment: Big Pharma saw that ketamine therapy is inevitable, and they wanted their cut.
Big Pharma has three main tools to protect its monopolies: patents, the FDA, and revolving door relationships with insurance companies.
It’s a simple concept but takes billions of dollars to execute: they patent a drug so that no one else can make it, get FDA approval so that no one else can market it, and get insurance to cover it so that treatment costs are distributed across you the taxpayer and you the insurance premium payer. That’s right, when “your insurance covers it,” you still end up paying for it in the form of ever-increasing premiums paid for by you and your employer (who pays you lower wages because they’re paying higher benefits).
Ketamine presented a challenge to this model: the patents expired decades earlier, so Big Pharma couldn’t establish the linchpin of its monopoly.
But J&J got creative.
Ketamine is a mixture of two molecules – esketamine and arketamine. J&J synthesized ketamine, removed the arketamine, and patented using just esketamine to treat depression.
Then they got esketamine (named “Spravato”) FDA-approved for depression, and got insurance to pay for it. In the process, they struck a deal with the FDA that requires esketamine to be administered in a clinic.
Now, they charge 88x the cost of generic ketamine to give patients a microdose of esketamine with an awful 2.5 hour observed experience and zero psychosocial support to leverage the neuroplasticity of ketamine.
You might think that with an 88x price tag, FDA approval, and insurance coverage, esketamine would be more effective than ketamine, right?
Nope!
J&J never ran a study to see if esketamine was more effective than ketamine. Their interest wasn’t in the best mental health treatment — it was in the most profitable mental health treatment.
But others did run those studies, and found that esketamine is actually less effective and more expensive than ketamine.
That hasn’t stopped it from becoming a blockbuster drug for J&J, making them a billion dollars last year — funded by your tax dollars and insurance premiums.
I founded Mindbloom to build the premium psychedelic medicine experience with the best outcomes at a price that everyday Americans can afford, like what Apple did for computers. We combine ketamine therapy in the comfort and convenience of your home with a premium support system including psychiatry, 1:1 coaching, group therapy, a client community, guided intention setting, AI voice journaling, 100 guided audio tracks, a welcome kit, Masterclass-style mental health programs, and way more. And Spravato still costs 14x more per session.
Between IV ketamine clinics and Big Pharma, you now have an alliance of strange bedfellows with a massive financial interest in keeping ketamine in the clinic and prices high.
When Mindbloom challenged the clinic paradigm, I knew the establishment’s immune defenses would kick in, and I haven’t been disappointed. We’ve seen:
Big Pharma lobbyists attacking at-home ketamine therapy (one openly said, “We’re coming after Mindbloom”)
Legacy media hit pieces quoting IV ketamine providers and J&J consultants spewing unsupported claims and intellectually dishonest fearmongering while failing to disclose their conflicts of interest
FDA warnings about compounded ketamine that cite only 6 adverse events over 7 years, and read like advertisements for Spravato (setting aside that tens of thousands of Americans die from benzos each year)
But I actually expected worse – which is why Mindbloom’s at-home ketamine therapy didn’t start with the best possible ketamine product.
Why Injectable Ketamine Therapy?
I started Mindbloom to transform lives and the world by radically increasing access to psychedelic medicine and creating the best experiences and outcomes.
We began with ketamine therapy not just because it was legal, but because we saw the transformational impact this medicine would have if we pulled it out of the clinic and made it more accessible, affordable, and approachable.
From the start, I wanted to offer intramuscular or subcutaneous injectable ketamine. In my and most providers’ experiences, these are the best routes of administration:
Most consistent, powerful, and effective sessions
Smooth 2-5 minute onset (vs. uncomfortable zero-to-sixty with IV and longer with oral and intranasal)
Better experience than IV (needle in arm) without the taste issues of oral and intransal
Ketamine can be injected into your stomach with a tiny insulin needle. It’s less painful than a mosquito bite.
It’s an even better experience than IV administration, and without the administrative burden, cost, or requiring patients to stay hooked up to an IV for the entire session. In fact, we initially opened with a space in Manhattan that offered tablet and injectable ketamine while building the clinical outcomes and operational rails to go 100% at-home care.
Yet for years, we delayed rolling out at-home injectable therapy – not because it wasn’t the best choice for clients, but because we were scared.
I was scared that at-home ketamine therapy was already at the limit of what society would accept despite the 100+ clinical studies showing it to be safe and effective, and that adding the optics risk of needles would make it too easy for Big Pharma, IV providers, and legacy media to attack us.
I’ll never know if this was the right or wrong decision, but I’ll always feel ashamed and frustrated that we made a decision that wasn’t in the intellectually honest best interests of our clients because of fear.
While Mindbloom Tablets have delivered life-changing and life-saving results for tens of thousands of clients, like my dad, mental health isn’t one-size-fits-all. Some clients face challenges with sublingual ketamine due to variable bioavailability, anxiety around accidental swallowing, and discomfort holding the flavored medicine in their mouths.
We’ve long known injectable ketamine is safe, effective, and provides a better experience for many clients, but in a climate where innovation is dismissed as heretical, we prioritized playing it safe at the expense of the truth.
That changes today.
Over the past year, we ran a rigorous three-phase pilot of at-home injectable ketamine therapy under the supervision of a medical review board of psychiatrists, nurse practitioners, and researchers.
The results of our pilot exceeded expectations:
Total Clients: 952 treated for 3,397 injectable sessions
Efficacy:
80% of clients reported significant improvements in symptoms of depression and/or anxiety
81% of clients who had tried both options preferred injectable over sublingual ketamine
30% increase in consistency of session intensity
Safety: Only 4% reported adverse events (vs. ~40% for SSRIs, which are also more severe)
More for Less: Costs 60% less than average IV infusion at a clinic from the comfort and convenience of home with 10x more support
We’ve shared our pilot data with independent researchers, who will be publishing multiple studies on it. You can also read our white paper here.
At-home injectable ketamine therapy is the new gold standard in mental health.
What Comes Next
I knew the establishment would react to at-home injectable ketamine, but I thought they would wait until we actually launched it.
In August, the Wall Street Journal published an absurd hit piece about our pilot. They lied by saying that we gave Matthew Perry the ketamine involved in his death – we did not – and they lied about the experiences Mindbloom clients had during the pilot, as I discussed in an earlier edition of Psychedelic Optimist. For quotes, they relied entirely on IV providers and J&J paid consultants, and refused to disclose the conflicts of interest.
But amidst the Matthew Perry clickbait and other lies, they missed the real story: why we would embrace something so obviously controversial and, more importantly, who it’s meant to help.
Our mental health system is broken.
Losing my mother and sister because the system failed them was devastating. Losing them when there are 10X better treatments sitting on the shelf is enraging.
Mindbloom exists so that others don’t have to experience what I did.
By combining the quality of injectable ketamine with the comfort and convenience of at-home care, we’ve created the most personalized, accessible, and effective mental health solution available today.
What seemed heretical six years ago is now the standard of care — and we’re doing it again.
I launched Mindbloom shouting from the rooftops “Psychedelic medicine is here.”
Now I’m shouting, finally, “Mindbloom injectables are here.”