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July 20, 2025 • 14 mins
Original Air Date: July 20, 2025

Dr. Havina Malina heads The Keta Medical Center in Nj, which uses ketamine to treat various mental health issues when traditional meds fail. Among them: depression; anxiety; PTSD; OCD and bipolar issues.




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Episode Transcript

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Speaker 1 (00:00):
Welcome to Sunstein Sessions on iHeartRadio, conversations about issues that matter.
Here's your host, three time Gracie Award winner, Shelley Sunstein.

Speaker 2 (00:10):
Depression effects more than twenty million adults in the United States,
but about a third of them don't respond to traditional antidepressants.
Enter ketamine. Now, maybe you've heard of this treatment, maybe
you just know of the name joining me this morning,
doctor Aviva Molina. She is with Keta Medical Center, a

(00:35):
network of physician led ketamine therapy clinics. So, first of all,
welcome and explain. Isn't ketamine like a tranquilizer used by veterinarians.

Speaker 3 (00:48):
Yes, okay, so thank you for having me. I'm happy
to give a little bit of context for ketamine and
how we use it at our centers.

Speaker 4 (00:57):
So, ketamine is actually an old medicine.

Speaker 3 (00:59):
And around for many many decades, used for many things,
both in the medical context and in the non medical context.
But yet it is used for sedation in higher doses.
It was used as an anesthetic in the Vietnam War.
It was you know, on the battlefield, and it's been

(01:20):
used for other things. Yes, it has been used in
the past as a horse tranquilizer, but it is a
sort of interesting medication in that it sort of wears
a lot of different hats and has a lot of
different properties that make it sort of uniquely poised to
help in other medical contexts and specifically in the psychiatric world.

Speaker 4 (01:44):
And you know, while.

Speaker 3 (01:46):
Used for sedation for for decades in the anesthesia world
in lower doses, in the last twenty years it's been
studied and shown to be safe and effective to treat depression,
anxiety and PTSD in a way that traditional antidepressants just
can't or don't. So, you know, Mental Health Awareness Month

(02:09):
is a perfectly apt time to kind of communicate to
people that you know, there is hope and ketamine can
sometimes be that hope, that sort of missing link in
their psychiatric treatment plan.

Speaker 2 (02:25):
Is this a recent treatment for mental health?

Speaker 1 (02:30):
Right?

Speaker 4 (02:30):
So there's there's multiple forms of ketamine.

Speaker 3 (02:33):
The intravenous form has been studied, like I said, for
almost twenty years now, and it's been used for many
years in ketymine centers like my Hours to treat you know, depression,
anxiety and PTSD.

Speaker 4 (02:49):
It is off label.

Speaker 3 (02:51):
There is another forms, bravado s ketamine, which is the
nasal form of ketamine that's been FDA approved in twenty
nineteen for treat and resistant depression, but both in the
last I would say ten years have been picking up
kind of momentum in terms of their efficacy and their

(03:12):
ability to really kind of bill fill a niche in
terms of you know, as you mentioned before, many patients
struggle with depression or on antidepressants and are still inadequately treated,
are still experiencing symptoms, and ketamine can kind.

Speaker 4 (03:29):
Of fill that.

Speaker 2 (03:30):
Is this covered by insurance, so ivy.

Speaker 3 (03:33):
Ketymine because it's off label, it's not covered by insurance,
but spravado the nasal, the nasal spray is covered by insurance.

Speaker 4 (03:41):
It is FDA approofed.

Speaker 2 (03:43):
Is the intravenous I mean, what is the difference between
the intravenous and the nasal spray in terms of effectiveness
or how long it takes to get an impact.

Speaker 4 (03:56):
Sure.

Speaker 3 (03:57):
So fundamentally, ketamine, any type of ketemine, any root of administration,
works differently than traditional anti depressants on the brain, and
this is why it's so useful.

Speaker 4 (04:10):
It creates.

Speaker 3 (04:12):
One of the ways in which it works, which is unique,
is that it creates new neural pathways.

Speaker 4 (04:19):
In the brain.

Speaker 3 (04:20):
So both both you know, the ivy kedemine and the
spravado create these new pathways and in doing so it
can help people kind of reframe their thinking, their behavior,
of their emotional responses, and in turn what we see
sort of translated on the day to day patient experience
levels that their mood can be improved, their motivation, their engagement,

(04:44):
and you know, it can sort of move the needle
in a way that traditional medicines don't and does not
have any of the side effects that are unpleasant in
many of the traditional antide pressences. Having said that, you know,
ivy and spravado have different roots of aministration. So it
one is you know, intravenous through a vein a forty
minute infusion. Spravados and nasal spray both are given under

(05:08):
doctor supervision in a center like hours.

Speaker 4 (05:12):
And both are quite efficacious.

Speaker 3 (05:15):
There are sort of thros and cons to both, the
biggest difference being that the spravado is FDA proof, so
it's covered by insurance, whereas the ivy.

Speaker 4 (05:24):
Kedemine is off lable, so it's an out of pocket expense.

Speaker 3 (05:28):
They both have different cadences in terms of how often
you have to come in and the maintenance schedule, the
length of treatment, but fundamentally they work similarly on the
brain and require the same type of monitoring in office.

Speaker 2 (05:42):
How soon though, do you see are you alleviated from
the depression or the PTSD.

Speaker 3 (05:51):
This is one of the beautiful aspects of ketamine. People
can feel relief after one or two treatments.

Speaker 4 (05:57):
Even it works.

Speaker 3 (05:59):
Quickly, But of course there is individual variability for some
people who can take, you know, one or two treatments,
of other people you know, can take a few weeks
to start seeing improvements. But this is highly contrasted with
traditional anti depressants, switch take four to six weeks to
even start seeing any sort of dent or any improvement
in mood or motivation.

Speaker 2 (06:19):
I'm speaking with doctor Haviva Molina. She's with the Keta
Medical Center, a network of physician led ketamine therapy clinics.
Are there any side effects? Doctor Molina?

Speaker 3 (06:32):
So, the nice part about ketamine in that it's been
around for so many decades, is it's stood the test
of time and it's really safe in the long term.
It does not have any uh. It has not been
shown to have any adverse long term effects during the
immediate treatment while you're in the center, it's pretty well tolerated.
It's normal and expected that you feel a sort of dissociated,

(06:56):
kind of relaxed, dreamlike state. And again, most people find
this too very enjoyable and pleasurable. And in our office
we have all sorts of tools such as can bean
playlists and meditative options that you can use to kind
of as well as kedemine assisted therapy before the treatment
and after in order to sort of maximize the experience.

(07:18):
There's a small percentage of people that during the treatment
feel some nausea or dizziness, but it's transient, so by
the time you leave the office you're back to yourself.
At our centers, there's always a doctor in our supervising
making sure that you're tolerating it well, and we certainly
can give medication to alleviate those short term effects, but

(07:39):
fundamentally it's extremely safe.

Speaker 2 (07:42):
Okay, So why is Kenemy not the number one go
to for depression? Why is it positioned as if you
are not responding to any depressants, this may be something
that can be effective for you.

Speaker 3 (08:00):
So I think it's picking up a lot of momentum
in the psychiatric community in general. Change takes time and overcoming,
you know, the stigma of you know what, you know,
what it's used, you know, potentially recreationally in an unmonitored setting,
you know, or what it's been used in the past.

Speaker 4 (08:19):
You know, we have to get past that.

Speaker 3 (08:20):
And I think, you know, there's there's sometimes inertia in
the medical community in terms of taking on new options,
even if they're extremely safe and extremely effective as ketymine is.
But I do see increased interests and you know, our
clinics of the open door clinics in twenty twenty we

(08:41):
started this Kedemine center in twenty twenty one and now
we're we have five centers, So there is definitely interest
and people are realizing that they really want to advocate
for themselves and they want to feel better and this
is safe and an innovative option for them.

Speaker 2 (09:02):
And this can also be used for alcohol abuse treatment.

Speaker 3 (09:07):
Yes, so ivy ketymine and specific has been studied and
shown in multiple studies scientific studies to be very effective
to curb alcohol cravings, so it definitely can be used
for that as well.

Speaker 2 (09:25):
Are there specific mental health issues that show a greater
response to ketymine.

Speaker 3 (09:33):
So primarily ketamine is for depression treatment resistant depression, which
means that you've you know, you've tried over other modalities
of treatments. You tried, you know, other antidepressants, and you
either can't tolerate them because of the unpleasant side effects
or you just you're not seeing the improvement that you
want to see, you know. That's that's sort of the

(09:56):
main reason that ketamine is given. But it's also been
studied and shown be effective in anxiety TTSD. Rebuilding these
neural pathways in the brain is really the crux of
how we see people heal in their mental journeys, you know,
with respect to PTSD, and so you know, anxiety, depression

(10:18):
and PTSD are sort of all conditions that are very
appropriate for Kenny.

Speaker 2 (10:24):
Where are the CATA Medical Centers.

Speaker 3 (10:27):
So we have two centers in New York City Upper
west Side, Midtown, one in Westchester, UH one in New
Rochelle as well, which which is in Westchester and New Jersey.
We have one center so one New Jersey, one Westchester
to New York City, and we just opened in Brooklyn

(10:47):
last month.

Speaker 2 (10:48):
Down we are in New Jersey. We're in New Jersey Oradell,
Northern New Jersey. How did you get involved.

Speaker 3 (10:58):
So I am a trained and experienced emergency medicine physician,
and myself and my sister in law who's also doctor Malina,
doctor Haviva.

Speaker 4 (11:07):
She's doctor Cheryl Malina.

Speaker 3 (11:11):
It sort of was born out of and inspired from
COVID nineteen I believe it or not, the pandemic where
everyone is very focused on the sort of physical aspect
of the pandemic and the physical manifestation which was horrible
and terrible and traumatic in its own way. You know,
there was a mental health crisis that emerged that we

(11:32):
saw in the er where people came in with you know,
extreme psychiatric symptoms. We have been using ketymine em higher
doses for the other usestry and for sedation in the
emergency room for years, and we were sort of exposed
to this you know, new use, and we did a
lot of research on it, and we you know, spoke

(11:54):
to psychiatrist and we kind of in a grassroots kind
of way, sided to open up our first center in
aw Jersey and we started to see patients emerge on the.

Speaker 4 (12:04):
Other side of the treatment course and we.

Speaker 3 (12:07):
Were just just astounded by the incredible results and that
really inspired us to keep moving and keep opening these centers,
making the treatments accessible for everybody.

Speaker 2 (12:19):
I'm assuming that ketamine is really a treatment for adults.

Speaker 4 (12:22):
Only, yes, eighteen and older.

Speaker 2 (12:25):
And why is that?

Speaker 4 (12:27):
It's the way the studies were designed.

Speaker 3 (12:29):
There are other studies in the works for pediatrics, so
hopefully that will, you know, come to bear, but for
now it is eighteen and older.

Speaker 2 (12:41):
We only have a couple of minutes left. Doctor Haviva
Molina of the ke Medical Centers, What have we not
touched on here that you want the audience to know about?

Speaker 3 (12:53):
I just, you know, I want them to know that
that really, if you're struggling with depression, anxiety and PIZZASD
and feel like you've tried every option, I urge you
to really consider academy because we have just been blown
away by what it can do and how it can
transform lives, and it can really change people's perspective, their

(13:20):
ability to engage in their life. They can feel lighter
and brighter and the results are sustained, and you know,
it's just it's so unique in that way and being
innovative and safe.

Speaker 2 (13:31):
Give us an example of someone whose life was changed.

Speaker 3 (13:34):
Absolutely so one of our first patients that sticks in
my mind who you know, had a history of depression.
He had been on multiple antidepressants, if you know, you
know SSRIs in particular, but he'd also tried other classes
of antidepressants. But he just kept getting put on one
antidepressant another another, and it was basically just shuffling the

(13:58):
same deck of cards around and he really had lost hope.
And when he came in with us, you know, he
was just sort of rock bottom. And over time, you know,
with each session, he just you know, he was taught,
he was more engaged, even when speaking to us, you know,
he was dressed. You know, he just felt he was

(14:19):
able to put himself together. He told me he could.
He started to take jogs in the morning. He was
able to kind of get up and be more productive.
He could get to projects he wasn't able to sort
of motivate and engage in for many years, even within
his house, you know, and the range in terms of
you know, he's one example. I mean, I can tell
you hundreds of other examples of people's lives being changed,

(14:43):
and you know, just being so grateful to have access
to this treatment.

Speaker 2 (14:48):
Thank you so much.

Speaker 1 (14:49):
You've been listening to Sunstein sessions on iHeartRadio. A production
of New York's classic rock Q one O four point
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