In this episode, we sit down again with Dr. Matthew Mosquera, a Harvard-trained addiction psychiatrist, for a deep dive into ketamine treatment — from its surprising history to its emerging role in mental health care. We kick things off by clearing up common misconceptions. While ketamine’s party-drug reputation persists, we explore its origins as a surgical anesthetic developed in the 1960s and how it rose to prominence during the Vietnam War. Its safety profile and effectiveness at sub-anesthetic doses have since made it a powerful tool in psychiatric care.
We focus on how ketamine works neurologically. It enhances neuroplasticity, helping the brain rewire and reconnect neural pathways damaged by depression and chronic stress. This restoration of “functional connectivity” enables emotional regulation to return more efficiently. Dr. Mosquera explains that ketamine doesn’t just mute symptoms like many SSRIs—it opens a short window where behavior and mindset shifts can take root more easily.
From there, we get into the logistics. Most patients begin with an “induction phase” — twice-weekly treatments for four weeks. Sessions typically last two hours and include an active dissociative phase followed by a recovery period. We learn that visuals, out-of-body sensations, and introspective insights are common but not guaranteed. Dr. Mosquera emphasizes the importance of environment and mindset in shaping each session’s impact. Clinics aim to create a calming, supportive space, and providers monitor patients throughout.
We also explore the differences between esketamine (the FDA-approved nasal spray for treatment-resistant depression) and generic ketamine, used off-label for conditions like PTSD, OCD, and anxiety. While esketamine is tightly regulated and covered by insurance, off-label use often involves out-of-pocket costs and different methods of administration like IV or IM injections.
Toward the end, we tackle common concerns: who shouldn’t use ketamine, potential side effects, and why at-home ketamine therapy can be risky. Dr. Mosquera offers cautious optimism about ketamine’s future, citing the growing data on long-term benefits. He encourages pairing treatment with therapy, movement, and other healthy habits for best results. We wrap with quick-hit facts and personal reflections, including Dr. Mosquera’s thoughts on why he was drawn to this field in the first place — and his belief in helping people reset when traditional treatments haven’t worked.
Reach out to Dr. Mosquera: mjmosquera89@gmail.com
00:00 - Intro
01:58 - What Is Ketamine? (History & Origins)
04:02 - Ketamine in Medical Use Today
05:02 - Ketamine for Depression Explained
06:28 - What is Esketamine vs. Ketamine?
08:29 - FDA Approvals and Other Mental Health Uses
09:38 - Off-Label Ketamine Use & Clinic Access
10:31 - Cost of Ketamine Treatment
13:00 - How Ketamine Helps the Brain (Neuroplasticity)
17:01 - What a Ketamine Treatment Session Feels Like
21:28 - Side Effects and How Patients Typically Feel After
22:34 - Ketamine-Assisted Psychotherapy (KAP)
25:15 - Psilocybin vs Ayahuasca vs Ketamine
28:16 - Who Shouldn’t Use Ketamine
30:13 - How Long Do the Effects Last?
32:49 - Matthew Perry’s Death & Ketamine Safety
34:51 - Ketamine Use Postpartum and While Breastfeeding
38:09 - What to Expect from Treatment
39:03 - Ketamine as a Party Drug & What Is a K-Hole?
42:56 - Long-Term Side Effects of Overuse
43:42 - The Future of Ketamine Clinics
44:55 - Fear of Psychedelics: Advice for First-Timers
47:05 - Fact or Fiction: Ketamine Myths Busted
48:44 - Frequency and Dosage Guidelines
50:59 - Where to Find Dr. Mosquera
51:22 - Outro and Closing Credits
SIW Matt Lo Res
Speakers: Jon Gay, Diana Weil, Elara Hadjipateras, & Matthew Mosquera
[Music Playing]
Voiceover (00:01):
Welcome to Steeped in Wellness, brought to you by matcha.com. Here we spill the tea on wellness trends, personal growth, and the latest health news. Now, here are your hosts, licensed dietician Diana Weil and medical journalist, Elara Hadjipateras.
Diana Weil (00:17):
Hello, everyone. Welcome to this week's episode.
Elara Hadjipateras (00:20):
So, for this week's episode, we have our first repeat guest, Dr. Matthew Mosquera. Dr. Matthew Mosquera is a Harvard trained board-certified addiction psychiatrist and lecturer at Harvard Medical School.
He provides high quality, evidence-based mental health care through an open-minded, thoughtful, and dedicated approach. He's now working additionally in the ketamine treatment space as a Regional Director in Cambridge, Massachusetts.
Welcome, Dr. Mosquera.
Matthew Mosquera (00:46):
Thank you. What a warm introduction. Thanks, guys.
Elara Hadjipateras (00:49):
Do you feel like somebody just kind of wished you happy birthday or sing you happy birthday?
Matthew Mosquera (00:53):
Yeah, those have been the best words I've heard in a long time.
Jon Gay (00:56):
Are you forgetting the most important part of the bio for our purposes, Elara?
Diana Weil (00:59):
I know, I was like, “Wait a minute.”
Elara Hadjipateras (01:00):
Guys, I'm burying the lead a little bit here, but if you're watching this podcast currently, maybe you can see the family resemblance between me and Dr. Mosquera. Dr. Mosquera is my brother, Matthew.
Diana Weil (01:12):
And they like each other. They're friends.
Elara Hadjipateras (01:13):
Yes. We like each other.
Matthew Mosquera (01:15):
We do. Yeah.
Elara Hadjipateras (01:18):
(Laughs) So, I guess, Matt was previously on the podcast just kind of talking more broadly about mental health, and now, we had said that we wanted to kind of deep dive into ketamine because now that he's kind of specializing in ketamine treatment, it's kind of this up-and-coming thing that you're seeing, clinics pop up all over the US.
I just kind of want to roll back the tape real quick and, I guess ask, what is ketamine? Because the only association I really had with it up until a year ago was that it was a horse tranquilizer that sometimes … that was like a party drug that would put you in a K-hole. So, what is it, how did it end up entering the health and wellness space?
Matthew Mosquera (01:58):
That's a great question. So, we can kind of give the whole history, which I find to be fascinating. I think that's one of the most interesting parts of ketamine actually. So, I give this spiel a lot, so if it feels canned, I'll try to make it sound a little bit more vivacious.
So, ketamine, it's been around for decades, guys. It was invented in the 60s by a US chemist, this guy Dr. Calvin Stevens. And at the time, he was working for the biggest pharma group, definitely in the country, possibly the world, called Parke-Davis, later got bought out by Pfizer. And his higher ups went, “Dr. Stevens, we needed really good anesthetic medication,” so meaning one of those meds you take before surgery.
So, he goes in the lab and he works up ketamine. Fun fact, the medication that ketamine was replacing was actually PCP, basically. So, ketamine really is indeed new and improved PCP, and it works a heck of a lot better as you can imagine.
PCP was taken off the market shortly after its introduction, and it's a really good anesthetic agent because you could take a whole boatload of ketamine, either intranasally, intramuscular, IV, all these different routes of administration, and you'll pass out more or less, like you'll be ready for surgery, it'll provide pain relief, but you won't pass out.
It really tends not to depress the respiratory drive. It is a very manageable half-life, meaning how long it kicks around in the body isn't too long. Like really two to four hours compared to some other anesthetic agents that are really long-acting. Doesn't have any interactions, doesn't have many side effects, short term and then long term, quite negligible unless you start abusing it, like using it all day every day, which we can talk about later.
So, for all those reasons, it's been used in medicine, in emergency rooms, operating rooms around the world for both humans and animals. So, the fact that people think of it as an animal tranquilizer, that is entirely accurate, but the doses for horses are 10 times or more than compared for humans, which makes sense.
Diana Weil (04:02):
So, if you go get surgery, let's say you go get wrist surgery, are they going to give you ketamine as their preferred choice?
Matthew Mosquera (04:08):
Usually not. I mean, that being said, in the emergency room if they have to reset like a … if someone's shoulder gets dislocated and they need some quick, easy pain relief/mild anesthetic, yeah, they can give you ketamine.
You may not pass out, you may just kind of dissociate and not even realize it's happening, but it's used- like emergency room doctors, physicians are super comfortable with it for all those reasons that I listed because it is quite safe, which is nice.
Jon Gay (04:38):
Propofol is the more common one.
Matthew Mosquera (04:40):
More heavy duty, that's one that's really going to put you out, and that's typically given intravenously. Whereas ketamine, they can give you a shot, they can do it intravenously. What we do in the clinic is a lot of intranasal, all these different forms.
Elara Hadjipateras (04:54):
So, when we're taking ketamine outside of the operating room, how exactly does ketamine therapy work?
Matthew Mosquera (05:02):
Yeah, for depression?
Elara Hadjipateras (05:04):
I guess, yeah. Well, is that usually the primary way people are using it as far as mental health goes?
Matthew Mosquera (05:10):
I'd say it's what has the most efficacy at the moment, and it's what it's FDA approved for. So, whenever we're talking about getting a medication out to the masses and having insurance cover it, somewhere people can really have access to it, it's really what the FDA is going to approve.
Remember, so ketamine came on board in the 60s, it actually rose to fame on the battlefields of Vietnam, and then throughout the years has been widely used, I just love the history as you can tell. And then we didn't really start looking at it for depression until the late 1990s, early 2000s. And then it wasn't approved for what's called treatment resistant depression until 2019.
And then it got the secondary FDA approval indication for (I might botch the exact terminology) — but essentially a major depressive episode was suicidal ideation or behavior. Basically, a really bad depressive episode where you may have some suicidal ideation.
So, those two approvals, that's what the FDA approved esketamine for; that's the insurance-based nasal spray. And then I can jump into the way it works, but there is kind of some confusion these days, like what is esketamine versus ketamine? Do you guys-
Elara Hadjipateras (06:21):
That doesn't mean anything to us.
Diana Weil (06:23):
Yeah, I didn't even know that there were multiple-
Elara Hadjipateras (06:24):
Different ketamines.
Diana Weil (06:27):
Teach us.
Matthew Mosquera (06:28):
I will try to break it down. So, esketamine is a version of ketamine. So, just like we have, to explain this, like a molecule, you could think the ketamine molecule, it has a left sided configuration and a right sided configuration, just like we have a left hand and a right hand. These are both hands, one is a right one, one is a left one.
Jon Gay (06:47):
For those of you listening on the audio, Elara is holding up her hands to demonstrate.
Matthew Mosquera (06:52):
So, ketamine, the one that I've been talking about, that's been around since the 60s, it's generic, it's widely used. It typically comes in a combination of both the right-sided and left-sided configurations, AKA, what's called racemic mixture of the levo and dextro forms.
So, what they did when they wanted to create a nasal spray- that they could get a patent on- is that they isolated the configuration of ketamine that is most active at the receptor that we really want to emphasize that obviously the NMDA receptor.
So, ketamine, one of its many mechanistic properties, it is an NMDA receptor antagonist among many other types of elements of the mechanisms that are important. Esketamine is really just the S, the levo enantiomer of ketamine that's separated from the right. It's a little bit confusing so if I lost you there, let me know because I can always go back and clarify.
Jon Gay (07:50):
I want to see if I understand this correctly, and I feel like I can call you Matt since this is your second time on the show as opposed to Dr. Mosquera. (Laughs)
So, the esketamine isolates the most effective for this purpose, part of the overall ketamine, do I have that right?
Matthew Mosquera (08:03):
You got it, yeah. Nailed it, that's exactly it. I will say that there is some research right now looking at the other configuration of ketamine, the dextro form of ketamine. It has not been approved, it's still very much in clinical trials, but they're looking at that as well for maybe some other applications across medicine, including depression and mental health, but nothing yet. So, what we got is esketamine and it works pretty well.
Elara Hadjipateras (08:29):
And that's obviously been FDA approved for depression. But I've also seen that they're using ketamine to treat OCD, anxiety, bipolar disorder, migraines, but that isn't necessarily covered by insurance. But can you go to a ketamine clinic and be able to receive ketamine for those other things like if it isn't depression?
Matthew Mosquera (08:51):
Usually, yes. So, all those other indications would be considered off label uses for ketamine. That being said, usually, then if you're going to a clinic and you're seeking treatment for an off-label use such as OCD, such as anxiety, such as PTSD, which by the way, ketamine has some promise for — typically that wouldn't be the esketamine, that nasal spray just because that's more just for the depression piece because insurance will cover it.
So, if you're looking to get treated let's say for PTSD exclusively, you may get either the intravenous ketamine or intramuscular ketamine, that mixture once again, it's been around since the 60s.
Diana Weil (09:28):
So, could I just walk into a clinic and be like, “Hey, I have really bad anxiety, will you treat me?” And what would be the cost for going for an off-label use?
Matthew Mosquera (09:38):
So, you can't just prance on in and demand it (laughs), but you meet with the doctor, they would sit you down, you would kind of run through your history if they're like, “Yep, Diana has got true loop generalized anxiety disorder, it has some promise for that, let's give it a go.” They'll run through the risks, the experience with you, and then it usually would be an out-of-pocket cost.
Different clinics have different costs. I'd say $500 minimum per treatment is kind of the going rate here, and that's more for intramuscular. If we're talking intravenous, little more involved, having to put an IV in, that's going to run you close to a thousand bucks a treatment.
Granted, that's just kind of a ballpark, all treatment centers do it differently. They offer package deals, they offer therapy at the same time, which we can talk about, called Ketamine-assisted psychotherapy. But yes, so you have to get an evaluation, and then pay out of pocket for those off-label uses.
Jon Gay (10:31):
That takes us back to the question of how the FDA approved use does work- the esketamine for anxiety, depression. Walk us through how that works, if you would please.
Matthew Mosquera (10:42):
Big picture, it plays on our brain's ability to adapt. Like if you guys ever heard of the term neuroplasticity?
Jon Gay (10:48):
Could you explain that term real quick?
Matthew Mosquera (10:50):
Totally. So, neuroplasticity, to slow it down, it's just that our brain can adapt. But the important part of this is that our brain can adapt in healthy ways and maybe not so healthy ways. So not so healthy ways, you can think of someone that begins to use alcohol as a coping mechanism, our brain's going to adapt to that, and then it's going to become dependent on it, and our brain's going to look to it.
A healthy way is- think about developing a healthy new behavior, like you really get into working out. At first, it's painful and then it becomes more muscle memory, and it's something that you do every day without even thinking.
And so, our brains can adapt at various levels, and one of the levels that it can also adapt that is the structural level. I mean, it can change. It's plastic, it means that it has ability to kind of undo different things.
So, what we're going to focus on is this concept in the brain called functional connectivity, which is kind of how our brain regulates itself. We have one area of the brain talking to another area, talking to another area, kind of a lot of crosstalk. The more crosstalk, the better generally, and the brain kind of wants to remain an even homeostasis.
So, you can think of the brain as kind of a “checks and balances” type system, and when there's more crosstalk, the better. Because then our brain better regulates itself, and then we are better able to regulate our own emotions and just feel different emotions.
So, unfortunately, when you're in a state of stress, like a depressive episode, some of those synaptic connections (that's how the different neurons in our brains talk to each other), they wither away. They're what's called “stress sensitive.”
So, then our brain in that state of stress is really struggling to regulate itself, and then we as a result are struggling to regulate our own emotions, and quite frankly, just feel different emotions, which is why when you're super depressed, it can feel like you're in a dark hole where you're like, “Gosh darn, I want to feel differently, but I can't, I'm just stuck.”
It's because physiologically, your brain is struggling to regulate itself, and there's not a lot of crosstalk and it's hard for you to feel different emotions like one's physiologically. So, ketamine helps reverse that.
At the end of the day, through this whole mechanistic cascade, which we can dive as deep as you guys want, ketamine actually goes to the ends of our neurons, revs up protein machinery to form new connections. So, then our brains can better regulate itself, there's enhanced functional connectivity, and then we can better regulate our own emotions and feel different emotions pretty quickly.
Diana Weil (13:10):
In your opinion, how do you feel about it being used for OCD, anxiety, that kind of stuff, not just for depression?
Matthew Mosquera (13:20):
I think it has some promise. What I can tell you is what I've seen, there hasn't been too many studies published, which lead in the charge for ketamine or esketamine getting approved for OCD or anxiety, but it seems to help.
We have a lot of folks come into the clinic who have true blue major depressive disorder and generalized anxiety disorder. For whatever reason, the depression tends to lift first, and then all too often the depression lifts people are like, “Oh, I feel better, but my anxiety is now in the spotlight.” And the kind of the party line here is that we're like, “Hold on, it tends to take a little longer for the anxiety symptoms to quell a bit, but they do with time.”
Elara Hadjipateras (14:01):
So, this brings me into my question of how often are people doing ketamine treatments? Are they coming in weekly? Are they coming in for just one big dose? How does that process work?
Matthew Mosquera (14:13):
So, what you're getting at is what's called “treatment durability.” So, the jury is very much still out on treatment durability, meaning that whole mechanism that I just described, it sounds pretty cool, but does it last for five minutes, five days, forever, even after one treatment? We're still figuring it out.
But when it was approved, generally when folks start in the insurance-based nasal spray, the esketamine or if somebody's coming in for intramuscular, typically you start by coming in twice weekly for four weeks as part of the induction course to kind of kickstart the growth of these new synaptic connections to make them go from nonexistent to at least semi-permanent.
And then from there, a lot of times, folks wind up coming in weekly for some time until their symptoms have stabilized and you can kind of remain on it weekly and maybe come off your other meds or taper off the ketamine with the hopes that you've been able to get some benefit and pair it with other lifestyle interventions that are essential.
Diana Weil (15:11):
I'm curious about that. You mentioned that this helps to build new synapses. So, what you're doing during those four weeks, is that critical? Like if you choose to drink a lot, could you make things worse for yourself rather than better depending on what you do during that time?
Elara Hadjipateras (15:27):
Is there kind of a no-fly list? Like please don't do this while you're in your month of concentrated ketamine treatment, like please, you know?
Matthew Mosquera (15:35):
That's a good question. So strong, strong recommendation to not abuse substances or even, I mean, if you could avoid using them altogether during treatment, your chance of it being efficacious and actually effective is certainly way higher because it's just going to make it that much harder for those new connections to form.
And substances really kind of make it harder for us to regulate our own emotion; so you're kind of just shooting yourself in the foot if you're using substances alongside the esketamine treatment or ketamine treatment rather.
So, other things you can do to make it more efficacious is to pair it alongside, doing your best to develop some sort of an exercise regimen, even if it's just five minutes a day, consistency is key here. Trying your best to practice proper sleep hygiene, trying your best to eat a balanced diet, and then meet with a therapist.
Because I view all these things as kind of like a piece of the puzzle and ketamine at the end of the day, is just another tool for you to use alongside all those other interventions. And if you pair it with them, there's this beautiful synergy that happens where you're able to engage in them more readily with higher level of motivation, higher energy level, and then it kind of becomes the norm.
Elara Hadjipateras (16:51):
So, can you walk us through what an actual ketamine treatment session is?
Diana Weil (16:56):
I was just going to say that. Tell us the experience.
Elara Hadjipateras (17:01):
And I know that you've mentioned now, so there's like you can do it with just the little nasal spray or intravenously, but just kind of walk us through what that experience is like, what someone could expect.
Matthew Mosquera (17:11):
Let's talk about it maybe expectations which is always a big one, it's really important. So, the experience, it's different, it is what's called entering an unordinary state of mind. At the clinic that I work at, we have private treatment rooms, it is a medical clinic. Try to make it not feel like one though.
Try to make it very comfortable, very safe space where staff gets to know the patients, patients get to know the staff, full blackout shades in the room, very comfortable chairs, weighted blankets, blood pressure machines, we monitor oxygenation. So, you come in, and the nasal spray is actually administered by the patients themself under kind of the guidance of staff.
And I kind of break down each treatment is generally two hours long. I break it down to the active phase and then the recovery phase. So, the active phase is the first 40-ish minutes or so, and then you get to the peak and then you kind of come down to the recovery phase.
During the active phase, after the client has administered the intranasal ketamine or if the staff member has provided the intramuscular injection or the IV infusion – and by the way, the IV and the IM formulations kind of hit more quickly, so you kind of want to be really ready, whereas the intranasal kind of is a little more gradual on, gradual off, could be a more gentle in that sense.
But the active phase is notable for, you're going to experience some dissociation, which is this term for kind of an out-of-body “floaty” experience as I call it. You're not going to forget who you are or where you are, it's not going to be that intense, but it is going to be a little bit of a disconnection. And for some this can be startling, for others, it's like bring it on, this is great, I've been looking for this.
Along with it, you may likely experience some visuals in the form of a kaleidoscope of colors. To really kind of experience the visuals that's why we recommend eye shades, we recommend very chill, ambient music, we have playlists that we offer here at the clinic, it pairs nicely.
Jon Gay (19:12):
Like a wine.
Elara Hadjipateras (19:13):
Now is anyone speaking to you as this is happening? Like, okay, so I go in, I'm in a dark room, am I covering my eyes, putting something up my nose and then someone's in the room with me? Are they talking to me at all? Are they like, “Hey Elara, are you good? What's happening with you?”
Matthew Mosquera (19:30):
So, there's different ways of doing it. So, if you were entering into what's called ketamine-assisted psychotherapy, you would've a provider in the room with you the whole time, the full two hours. Most clinics are on staff like that, our clinic isn't, but we do do check-ins at the beginning, we have call bells to come in the room if someone's having a hard time or a great time, or if they just want a snack delivered or beverage, quite frankly, really whatever they need, and then we'll do-
Elara Hadjipateras (19:54):
Does that happen a lot? The people, are they just like, “I'm parched or I really want some Doritos.”
Matthew Mosquera (20:00):
We aim to please; we try to make it a comfortable experience. So, yeah, that's the easy part. And people are typically very happy to see you and appreciative. So, generally, no because during the active phase, it's a very internal type experience. Like all the different psychedelics on the map and I'll kind of lump ketamine in with the other psychedelics for the sake of this LSD, MDMA, psilocybin, they're all different houses on the same street.
They have similarities, but they're also different. Like psilocybin is more of an external experience. You want to go out and go on a hike and experience nature and be with people whereas ketamine, during that active phase that I described, it's quite internal.
Diana Weil (20:42):
And how long did you say that is? Like 10 minutes, 20 minutes?
Elara Hadjipateras (20:45):
40 minutes, right?
Matthew Mosquera (20:46):
40, but the really kind of intense-ish visuals would be like 20 minutes, and that's the beauty of ketamine. If the visuals with association's a little bit much for you, you can just remind yourself, “Well, you know what, in 10 minutes at this point, it's probably going to be over. And then it's going to fade away. I'll come back into my body.” And then experience the recovery phase, which is typically quite pleasant.
You have kind of a runner's high because one of the mechanistic properties of ketamine is that it's like an allosteric modulator, which is a very confusing term, but it tinkers with the endogenous endorphin system in the body. So, you feel good from that, and you have kind of like a runner's high for the last hour.
Diana Weil (21:28):
I mean maybe this is totally different and I guess it just depends on the drugs, but you know how sometimes if you do something the next day is not so fun, is it like a runner's high for everybody or do you have anyone who could potentially feel worse from that experience?
Elara Hadjipateras (21:43):
Potential side effects that come along with ketamine therapy.
Matthew Mosquera (21:46):
I'll just talk side effects. In session, those visuals can be a little dynamic. So, for some, if you have a propensity for motion sickness, like on a boat or a car, we can give some anti-nausea medication ahead of time. Some folks get a little nauseous, and then afterwards I see the more common would be the next day you may experience a little bit of grogginess, a little bit of fatigue, folks tend to kind of acclimate to that, they kind of get used to it.
That being said, if somebody's having dysphoric reactions, like really feeling low after treatment, we're going to watch them closely and decide if it's the treatment for them. It's not the norm, but it is something that we look out for.
Diana Weil (22:23):
And can you talk about if people are doing the, I think you called it therapy assisted ketamine treatment, what does that look like? Do you do the ketamine treatment and then go meet with a therapist or is that a separate day?
Matthew Mosquera (22:34):
So, it's typically the same day. Ketamine-assisted psychotherapy, but this is typically not covered by insurance. So, KAP, it's called Ketamine-Assisted Psychotherapy (the acronym KAP) is provided by a lot of clinics, a lot of clinics do it really well.
It's just going to be an out-of-pocket cost where you'll have a provider in the room the full two hours. Who knows, maybe the first hour you guys aren't talking, they're just kind of hanging out there with you. If you need them, they're there. And then during that recovery phase, you'll kind of come back into your body and you'll be able to engage and talk about what you just experienced and start integrating.
Elara Hadjipateras (23:07):
Have you ever witnessed someone having a pretty funny reaction to the ketamine? Like uncontrollable laughter for a 40-minute period. You don't have to answer it if you don't want to, but just …
Matthew Mosquera (23:19):
I'll put it this way. I'd say we get far more of those kinds of just like an ecstatic, really jubilant, kind of this is great. We have a lot more clients saying, “I just had a great session,” compared to folks being like, “That was the worst time of my life.” We rarely hear that.
Have we heard it? Sure. I think it's more triggered by someone's mindset going into it. So, we really do try to pay special attention in setting both mindset and the environment. So, when we meet with clients, especially for the first couple of visits, we'll pay special attention to their mindset going in. And if somebody's got a negative mindset prior to treatment, we'll hold off. Maybe today's not the day. Because if they're kind of dead set on it being a horrible experience, it's not going to be fun.
Jon Gay (24:05):
It's interesting, I think of a family member I have- who she doesn't like to lose control. She's never been more than buzzed off of alcohol, she's never been drunk, she's never tried marijuana and cannabis, any of that stuff. I feel like this would not be for her.
Matthew Mosquera (24:19):
Maybe not. I think we would have to coach her up a bit and really make her feel as comfortable as possible. But your description Jon makes me think of this is where dosing does come into play. So, classically, the first day for the intranasal, we provide a reduced dose just as kind of like a test to see how it goes, and some clients, that's all they need.
But there is a certain element that if you don't provide a high enough dose, you may not get the therapeutic benefit. Then you may just get some of the unordinary state of mind without the upside. So, if somebody is underdosed, we typically try to make sure that we've at least tried to provide adequate treatment dose before we deem it a success or failure.
Diana Weil (25:01):
So, why would you pick ketamine versus going to a psychedelic assisted therapy program and doing mushrooms or yeah, I guess mushrooms would be the only one that else is legal.
Elara Hadjipateras (25:12):
Think of mushrooms or going and doing ayahuasca.
Matthew Mosquera (25:15):
For one, insurance can cover it if you're eligible for treated resistant depression, so you don't have to break the bank. Because all those other places, whether it's psilocybin center or therapy with it, it's going to be out of pocket, and we don't want people to break the bank.
And if it's something that works, you want them to keep having access to it so then they can continue to feel better; not to be on it for the rest of their life. But if they're going through a tough time, you want them to be able to utilize it.
And then in addition, I find that ketamine is really manageable. The half-life that I mentioned earlier, how long it's in the body for is not too long. Whereas psilocybin, ayahuasca, you're talking psilocybin, it's going to be six hours or more, and then for ayahuasca, we're talking like full on daily situation there where we have to-
Jon Gay (26:07):
I have to ask, what is ayahuasca? You guys have mentioned it, I've never heard of it.
Diana Weil (26:11):
Jon, you don't know what Ayahuasca … oh, Jon.
Jon Gay (26:12):
I'm sheltered.
Elara Hadjipateras (26:13):
No, you explain. Other than puking in a bucket and seeing it looks like a very-
Jon (26:22):
Sounds awesome.
Diana Weil (26:23):
Sacred to Peru, I think. Anyways, Matt, you'll probably do a better job.
Matthew Mosquera (26:27):
Sure. So, ayahuasca generally – and I'm not an ayahuasca shaman, so I'm kind of shooting from the hip here. It's a psychedelic brew. It's made from this plant, I think it came from the Amazon. It's been using traditional healing ceremonies usually in South America, but the main ingredient kind of the active, the psychoactive component is this chemical called DMT, what our body releases when we dream and it's a very intense experience.
So, DMT stands for dimethyltryptamine, and yeah, it's pretty intense. When folks experience it, they're really going to have this profound dissociation. It's kind of like ketamine, but everything is going to be much more profound.
Jon Gay (27:16):
So, it's like that flower in Black Panther?
Matthew Mosquera (27:18):
Yeah, yeah. There we go.
[Laughter]
Elara Hadjipateras (27:22):
Yeah. Actually, yes.
Jon Gay (27:24):
For a second, I thought that I was getting lost because I got silence for a second, and then it all clicked for all three of you at the same time (laughs).
Elara Hadjipateras (27:29):
No, I was like, “That's how they got the power.”
Diana Weil (27:31):
Isn't DMT the chemical that's released when you're born and when you die? Is that true or is that just a myth that they tell?
Matthew Mosquera (27:36):
Same, the same, I think. And in theory, yes. So, it's all kind of similar in that sense. There is some psychedelic research into more manageable forms of DMT that don't involve purging. Because one of the ayahuasca components is that a lot of times people will throw up during it, it's almost like a necessary part.
And it can be quite destabilizing if you go into it without kind of a really stable kind of mindset of what you're looking for, and a lot of safety wrapped around it because I think the other side effects are a little bit more intense than ketamine. Ketamine is a lot more gentle, a lot easier to manage in a lot of different ways.
Diana Weil (28:13):
Who would you not recommend ketamine for?
Matthew Mosquera (28:16):
That's a great question. I would not recommend ketamine to someone who has a history of some sort of primary thought disorder, which is another term for schizophrenia, schizoaffective disorder. Someone that's been struggling with that because there are some psycho mimetic effects, meaning that the visuals that I just described, that's because there's some dopamine receptor agonism. It kind of fiddles with the dopamine receptor and that can worsen theoretically somebody who has schizophrenia.
It could have them hear more voices, more intense visuals and really throw them off. So, that would be a no-go for me. Someone that has profound liver dysfunction, someone who's just had a heart attack, someone who has a history of seizures is not a complete contraindication.
Ketamine isn't really known to trigger seizures, but we don't want to really mess around because it is a little bit of a strain on the body, ketamine is. So, someone has a history of seizures, we want to chat with their neurologist ahead of time, make sure they're on the right meds, and that we can watch them closely. Those are just a few off the top of my head.
Uncontrolled high blood pressure is another one, which probably the most common one that we see. So, ketamine increases blood pressure for everyone. Young, old, big, small, doesn't matter – is to the equivalent of if somebody walked up a few flights of stairs, it happens, it kind of peaks at that midway point, then it comes back down generally.
So, if somebody has poorly controlled high blood pressure, we're going to recommend, “Hey, go see your doc, maybe get started on a med and come back,” just so we can be completely safe with everything.
Jon Gay (29:54):
Matt, in terms of course of treatment, I know sometimes SSRIs- if you go on one, you might be on it for the rest of your life. I know sometimes folks go on one if they're going through, as you mentioned earlier, a really particularly hard time temporarily. This ketamine treatment, I know we're kind of early in the game here, is it typically a shorter-, medium- or longer-term treatment or does it depend on the individual?
Matthew Mosquera (30:13):
It depends. It depends. And we're still early in the game. In the American Journal of Psychiatry just this month they released a few articles on long-term efficacy as well as side effects and kind of the conclusion of a lot of them was we need to keep watching, we need to keep studying folks, we need to … like gathering data on these long-term effects.
So, we have a good amount of clients, Jon, that wind up coming off their SSRIs and remain on ketamine just because the SSRIs have these side effects they don't like. Some side effects, like whether it's nausea, headache, or sexual side effects, which are quite rampant with SSRIs.
Jon Gay (30:52):
Lack of sleep, lower ability to drink alcohol or like one or two drinks knocks you on your butt. Yeah, I've heard a lot of that with SSRIs.
Matthew Mosquera (30:59):
Yeah. So, there's a lot of other side effects. A lot of people can't tolerate them, so they prefer to remain on something like ketamine.
Elara Hadjipateras (31:04):
What about patients bringing ketamine home from clinics because I know right there-
Matthew Mosquera (31:09):
Good topic.
Elara Hadjipateras (31:10):
Like Matthew Perry, like Matthew Perry just keeps popping into my mind.
Diana Weil (31:13):
Oh, is that what he died of?
Elara Hadjipateras (31:14):
He died of a ketamine overdose, yeah.
Matthew Mosquera (31:17):
Let's clarify that. I'm glad you brought that up. First off, spravato, the insurance, this nasal spray is very tightly regulated. The vast majority of our clients here receive spravato because insurance pays for it and we store it here very safely. You can only administer it in a medical clinic like our clinic here. You cannot take it home, you cannot-
Elara Hadjipateras (31:35):
For the state of Massachusetts or is that countrywide?
Matthew Mosquera (31:37):
For America. For the United States of America. So, that's a good thing because it keeps it above board and it ensures that patients are coming to a safe place with medical attention to receive this treatment. If anything goes awry, you can immediately get tended to, in my opinion and strong opinion, it's the best way to do it.
There's a lot of mail order companies- Mindblooms of the world, that's just the one off the top of my head or just honestly meeting with a private practice provider where they can prescribe you ketamine and you can pick up a vial or lozenges at all various forms and they'll instruct you how to administer it yourself at home.
As you can imagine, that can quickly go awry if somebody starts misusing it, using too much or accidentally uses too much and that has an adverse reaction, a lot of bad things can happen. So, there are some spots that are able to do it, but I think it's quite risky.
And then Matthew Perry, so he did not die necessarily of ketamine overdose, he did have ketamine in his system and like I mentioned at the start, ketamine really doesn't suppress the respiratory drive even at high doses, but you'll pass out if you take enough of it, and he unfortunately, passed out in a spot that you can’t-
Elara Hadjipateras (32:49):
In a jacuzzi, right? Wasn't it in a jacuzzi?
Matthew Mosquera (32:50):
A body of water. So, you don't want to pass out in a body of water.
Elara Hadjipateras (32:54):
Don't do ketamine in a body of water.
Matthew Mosquera (32:56):
He was getting ketamine from an outside provider, so who knows how much he was using, whereas if he was receiving it at a clinic obviously, it'd be a different story.
Jon Gay (33:05):
It reminds me a little bit, I don't want to stereotype about Los Angeles and doctor shopping and whatever, but we mentioned propofol earlier. That was what Michael Jackson died of because he had a private doctor that, if you remember, he would call it his milk, “I need my milk to go to sleep.”
And he had this doctor who would give him propofol every night so he could sleep. I mean, terrible misuse of the intent of that drug. So, again, we don't know what happened with Matthew Perry. I don't want to accuse anybody of anything, but if you have means and fame, you can get access to things that you maybe shouldn't have access to.
Matthew Mosquera (33:40):
Totally agree with that. VIP level of care, you think you're getting high level of care, but when you go outside of standard treatment norms, bad things can happen.
Diana Weil (33:48):
Elara, you had told me when you were pregnant that you were going to think about consider doing ketamine postpartum and is that something that you have done? Do you still want to do it?
Elara Hadjipateras (33:58):
I haven't done it. I told myself it would be on the table if I felt myself dipping into feeling postpartum depression, which this time around, I have not as of late. Could that change a week from now, a month from now? Possibly.
But overall, I have to say my son Archer (who's now three months), he's just been a lot easier of a baby compared to my first. Not to say that Koa was like a hard baby, but the first time around, you have no idea what you're doing. Everything's just kind of heightened. You're stressed, you're just like, I don't know anything that's going on, so you inevitably just have much less downtime.
Jon Gay (34:35):
This is a perfect time for a callback to our “before and after” episode, before and after Archer was born with Elara. I'd encourage our listeners to go back and listen and watch that episode.
Elara Hadjipateras (34:43):
Yeah, absolutely. But at this point in time, has anybody come to the clinic kind of seeking out ketamine specifically for postpartum depression?
Diana Weil (34:51):
And can you do it postpartum? What are the rules around that?
Matthew Mosquera (34:55):
Sure. That would be another off-label use where you can kind of treat a depressive episode, triggered by a postpartum setting. You just have to have a provider evaluate you and monitor you closely.
It would be more of an off-label use, so you wouldn't be eligible for the insurance based nasal spray, but sure, we could try it. And I'd recommend coming into a clinic to do it so you're doing it as safely as possible, but there's no promise there.
Diana Weil (35:23):
What about breastfeeding, can you do it while breastfeeding, or is that contraindicated?
Matthew Mosquera (35:26):
Generally, no, that is one of the questions we ask. Like are you pregnant or trying to get pregnant or breastfeeding? It just really hasn't been studied. It's not a known teratogen meaning like something that's going to be harmful to a fetus if someone's pregnant, let's say.
We just don’t know enough, and in the world of not knowing enough when it comes to pregnancy or breastfeeding, we just kind of steer away from it, unfortunately, unless you've tried everything else and you're in rough shape.
Elara Hadjipateras (35:51):
So, now going back, at the clinic, what type of license do people have in order to administer ketamine?
Matthew Mosquera (36:00):
Great question. So, any MD, if somebody has an active medical license, they're certified with the DEA and they have a DEA number, you can provide it. You can prescribe it to patients. Yeah, you basically just need a DEA license, and then you have to document why it's indicated, what you're going to monitor, that you've reviewed side effects, and whatnot. So, documentation's key and yeah, having an active DEA license as well.
Elara Hadjipateras (36:29):
But is it always necessary to have an MD? Is that the person who's leading you in and out of the room, answering you when you ring your bell?
Matthew Mosquera (36:37):
Technically, no. Technically some places and nurse practitioners can also prescribe it because NPs can have their own DEA license unique to them as well.
Diana Weil (36:47):
So, what made you want to go into this? What about ketamine therapy is interesting to you?
Matthew Mosquera (36:53):
In a funny coincidence, before I worked in the space, I actually went to a conference, the American Psychiatric Association, the APA conference. This was back in New Orleans, I want to say like three or four years ago, and I heard this psychopharmacologist, Dr. Stephen Stahl give a talk on the mechanism of ketamine, and I was just fascinated by it.
I'm like, “Wow, I did not know that's the way it works. I've always heard about this thing growing up. It was this big, spooky entity that people use as a drug of abuse.” So, I was trying to keep an open mind, and then I learned more about it. I just decided to look into it, and it turns out that it helps people.
And it wasn't until I heard from patients themselves as far as their before and after and their experience, that it really won me over because you have a whole bunch of patients across America that have had super bad treatment resistant depression, they've really been struggling, life upended, and then they find this treatment and it really helps them quite tremendously, and they feel differently pretty quickly.
And in the world of mental health, the world of medicine, if you can provide a treatment that really helps people that quickly, it's a win-win.
Jon Gay (37:59):
Matt, I know it's going to be different for every patient and every situation, but what are some reasonable expectations for efficacy of the ketamine treatment?
Matthew Mosquera (38:09):
This is one of the most important topics that I review with everyone that comes into the clinic just to kind of get everyone on the same page, and I'm very straightforward with that. I say, “Folks, then I'm like, look, let's talk about what ketamine is not.”
Ketamine is not the kind of treatment where you're going to have some big revelation of why you feel the way you feel, why the world is the way it is. That is just straight up is not going to happen. Maybe that'll happen if you do an ayahuasca trip, but it will not happen with ketamine.
Sometimes folks are disappointed, but then I flip it, so I'm like, “Look, what you can expect is an opportunity for a mindset shift, to start viewing the world a little bit more optimistically with a little less pessimism. And if that takes root, suddenly motivation ticks up, energy ticks up, life will still be hard. Life's always going to be hard, but hopefully, it's a little bit less hard, and it has this gradual snowball effect to kind of have that mindset shift.
Diana Weil (39:03):
Can you talk about using it as a party drug, and what a K-hole is? Because that was the way that I knew ketamine when I was in college.
Jon Gay (39:11):
You had a more exciting college life than I did.
[Laughter]
Matthew Mosquera (39:15):
So, as an addiction psychiatrist, I have a special interest in this and I want to pay special attention to it. And I've looked into the numbers, and it is on the rise as far as a drug of abuse misuse for various reasons.
And folks, it's a funny party drug in the sense that at low dose can be kind of stimulant-esque, and then at higher doses you get that profound association where you kind of enter a K-hole. As far as the treatment doses we provide here is probably somewhere in between those two experiences.
Jon Gay (39:45):
What is a K-hole?
Matthew Mosquera (39:47):
A K-hole is, like I talked about that kind of the out of body floaty experience. It's an intense version of that where folks are really kind of … they're sedated, they're still breathing but they're kind of separated as far as mind and body. It doesn't last very long. Once again, it's going to last for 20, 30 minutes and they'll come out of it, but it's usually pretty intense.
Elara Hadjipateras (40:11):
Yeah, I've seen people at parties in a K-hole where they're in the corner, they're sitting there, they're kind of just staring off into space. They may be heavily sweating, maybe not, they're nonverbal, they're just kind of like a bobblehead just hanging out, and then it's like they just come back too.
Jon Gay (40:28):
Can I ask a tangent question here with your background as an addiction psychiatrist, Matt?
Matthew Mosquera (40:32):
Yeah.
Jon Gay (40:34):
I've seen anecdotal evidence that Gen Z college age students, they're not drinking as much anymore, and maybe it's because cannabis is more readily available in a lot of places and we're talking about these party drugs. I go back to my alma mater at Syracuse, most of the bars on campus are closed. Like these kids are not drinking anymore, I feel like they're doing other things. Have you seen that in your line of work?
Matthew Mosquera (40:59):
I think so. Like the rates are definitely on the rise in youth populations, especially. I think it's a variety of reasons. I think the youth pop maybe is ahead of the Gen Z, the baby boomers realizing that alcohol is also quite toxic. Maybe they're onto something here, but I guess they're looking for some other vices.
And ketamine’s popped up, given that I guess cocaine use … I'm not sure the exact rates, but there's been a lot of talk in the media about being spiked with fentanyl and doesn't appear that the ketamine care is as much. I could be wrong, but that's just kind of what we've been hearing. So, I think that also contributed, so kind of from both these other substances that maybe they would've used are not as popular, so then ketamine has kind of filled that gap.
And I don't want to say as far as a harm reduction type gut standpoint, I think there's far more destructive capability of some of these- cocaine, fentanyl obviously compared to ketamine. But to get to your question, it's on the rise, and it's something that I definitely take note of because that's where you see the long-term side effects of ketamine for these daily users.
Like at the dose and the frequency that we give ketamine at the clinic, long-term side effects are largely negligible, and I counsel patients on this a lot. But if you start abusing ketamine, using it every day, that's when you're going to get inflammation of the bladder, this ulcerative cystitis, these abdominal cramps called the K-cramps, and then some headaches because too much of that neuro enhancement isn't a good thing.
So, you get these things called only lesions, which are these kind of semi-permanent areas in the brain of dysfunction. So, yeah, it's on the rise. Something that we take note of, which is all the more reason why I appreciate that clinics like the one I work at exist so you can kind of provide the treatment the right way, and do your best to prevent misuse.
Elara Hadjipateras (42:56):
Now, where do you see ketamine therapy heading in the next 5 to 10 years? Is there going to be a big shift in any direction that comes to mind?
Matthew Mosquera (43:04):
Yeah, I get asked that a lot. I don't think it's going anywhere. That's the first question I had to determine for myself just because it works, it's safe, it works quickly, it helps folks to feel differently- not overnight, but within the induction course, within four weeks for a lot of people that have been just craving to feel differently out of this kind of depressive funk for quite some time.
And I think if administered the right way, it's going to have a role in psychiatry mental health for the foreseeable future.
Elara Hadjipateras (43:37):
What's your thought on at-home ketamine programs versus in-clinic treatments?
Matthew Mosquera (43:42):
I am biased. I think you can do them possibly well, but at the same time it's higher risk. It's higher risk, it has to be, I think for a select few, I think it's appropriate. But for the vast majority of individuals: in clinic, I would strongly recommend.
Elara Hadjipateras (44:00):
Do people ever come in and do ketamine together? Do you ever have, say, a couples therapy? They're like, “Instead of a couple's therapy session, like we just want to come in, we don't want to go see a couple's therapist, we're having marital issues, let's just go do ketamine together?” Like is that an option? It's just like when you go in for a couple's massage.
Matthew Mosquera (44:17):
I haven’t provided one yet, it’s a cool idea, and there may be some promise there. We're not set up to do that exactly. There's one chair per room, but hey, you never know in the future.
Diana Weil (44:26):
I feel like we got to wrap up here soon, but I have a question for you. I am someone who I can handle a buzz, but I can't do any other substances because it brings up so much anxiety for me, that feeling that those psychedelics just really don't mesh with my brain, I guess.
So, like someone who maybe has a lot of fear and anxiety around like any sort of psychedelics, what advice would you have for someone who's maybe interested in ketamine but has that fear and anxiety?
Matthew Mosquera (44:55):
It's a great, great question and I get asked it a lot, so what do I tell folks? We do our very best to provide psychoeducation prior to the treatment. I find that knowledge here is power just to help try to reduce as much uncertainty as possible.
Of course, going into it, it can be this kind of big, scary alternative state of mind for someone that struggles with control and letting go of it can be quite triggering, so you say you do your very best to coach them through it.
You also try not to give too high of a dose because then it's going to be a little bit too much. But you don't want to underdose either. So, you also coach around dosing and you're going to provide the lowest dose that you need to get the effect that you're looking for, and then you could always try it.
The thing with ketamine, it doesn't last for very long, and if somebody's not having a good time in the treatment session, we can come in the room, put the shades up, put the feet on the ground, do some breath work, do some grounding skills, provide a cold pack, and folks typically tend to regulate pretty quickly. So, it is not for everyone, but it's for a lot of folks, even folks that are quite trepidatious going into it.
So, working with a really strong group of providers, folks can kind of coach you along the way is essential. So, you can imagine if you have that mindset and you're trying it out at home, probably not a recipe for success. So, that's why clinics are important.
Elara Hadjipateras (46:25):
Jon, do you feel any urge to do ketamine at any point in your life after this podcast?
Jon Gay (46:31):
You know what, I'll be honest, I had only heard of it as a party drug or something that people had abused before this conversation. And I have issues with anxiety, and I have been on an SSRI for about 10 years now, so I have found this conversation absolutely fascinating.
Elara Hadjipateras (46:49):
Matt, we're going to bring you through just a couple really fast questions, shoot off the hip in terms of the answer here, so we can just kind of move through them. Diana and I will just kind of pivot back and forth.
So, fact or fiction: will ketamine clinics be as common as yoga studios?
Matthew Mosquera (47:05):
Fact.
Diana Weil (47:08):
Fact or fiction: the benefits fade quickly after treatment.
Matthew Mosquera (47:14):
This is what I want to say, it depends on the patient. I can give a long in-depth answer, but I'm going to say actually fiction because what separates ketamine from the rest is that you're going to have this long-lasting effect if done correctly in an ideal setting.
Jon Gay (47:28):
Fact or fiction: everyone experiences vivid visuals as you described earlier.
Matthew Mosquera (47:33):
I'm going to say fiction just because the vast majority do, but the vast majority does not equal everyone. So, most do, but not everyone.
Elara Hadjipateras (47:42):
Fact or fiction: you need to set intentions and go in with a good mindset before a session.
Matthew Mosquera (47:48):
Fiction. That said, setting intentions is an essential piece for some of our clientele, but for others, it can feel like added pressure, so.
Elara Hadjipateras (47:58):
Fact or fiction: every time you go in for a ketamine session, you need to be doing more ketamine each time.
Matthew Mosquera (48:05):
Fiction.
Elara Hadjipateras (48:08):
Interesting. So, you won't build up a tolerance necessarily.
Matthew Mosquera (48:11):
There is some habituation that can take place. That's why meeting with providers regularly to kind of update the treatment plan is essential. Higher doses can be considered, but not necessarily. If some folks on the same dose weekly for up to a year or more, and they're doing just great.
Elara Hadjipateras (48:27):
What is the closest you'll allow to ketamine sessions for the same individual to take place? You said twice a week?
Matthew Mosquera (48:35):
Folks start out doing it twice weekly for four weeks, then we stretch it out to weekly, and we kind of remain at that for the foreseeable future.
Elara Hadjipateras (48:44):
But have you ever had someone come in where they come in, they get the ketamine treatment, and then they come back the next day and they're like, “That felt great. Can you do that again?”
Matthew Mosquera (48:51):
Oh, I see. So, in the induction course, we generally at least want to have a day in between treatments during that initial induction phase, if not a couple of days.
Elara Hadjipateras (49:03):
Well, if you remember from the last time you were on the podcast, Matt, we like to round things out with two questions. Right now, does anything come to mind that you've recently had to learn the hard way?
Matthew Mosquera (49:17):
Oof, for sure, let's see. How can I phrase this? Something I've learned the hard way. I guess when you're in a situation, you realize the truth is always going to have to come out at some point, and sometimes it can be really hard to deliver, but it's best to do earlier rather than later. Like at some point, you're going to have to deliver the message. That may be vague, it may hit for some, but …
Elara Hadjipateras (49:49):
Does it hit for you, Diana? It hits for me.
Diana Weil (49:51):
Yeah, it hits for me.
[Laughter]
Jon Gay (49:53):
I think it hits for all of our listeners too.
Diana Weil (49:56):
Sort of the opposite of that question is: what's a life motto or phrase, something that you live by that you've learned from someone else?
Matthew Mosquera (50:08):
So, I'm actually going to go to the Matthew McConaughey Oscar's acceptance speech from a few years back where he got on stage and he remarked that his hero is: himself in 10 years. I think about that a lot.
Some people were critical of his speech, self-aggrandizing. I thought it was actually kind of beautiful in the sense that he's constantly trying to push himself to evolve, to be kind of his best version of himself and not to be complacent. And also, I think it's a special lesson in self-love as well to kind of put yourself first and invest in yourself. So, I think it's an awesome message.
Jon Gay (50:46):
Alright, alright, alright, I think it's a perfect place to leave it.
Elara Hadjipateras (50:50):
You beat me to it, Jon. Matt, if anyone wants to find you, learn more, where can they find you if they want to work with you, if they're interested in your services?
Matthew Mosquera (50:59):
They can email me or call me.
Jon Gay (51:02):
And what's your email?
Matthew Mosquera (51:03):
Sure. Why don't we go with my private practice email, it's mjmosquera89@gmail.com.
Jon Gay (51:15):
We’ll put that link in the show notes as well.
Diana Weil (51:18):
Thank you, Matt. Appreciate all your knowledge.
[Music Playing]
Voiceover (51:22):
Sip, savor, and live well with new episodes of Steeped in Wellness every Wednesday. Follow our show free on Apple, Spotify, YouTube, or wherever you're listening right now. Leave your questions and comments below. Find us on Instagram at Steeped in Wellness Podcast or for more, click on matcha.com.