Joyous

Joyous is an at-home ketamine treatment service run by a public benefit corporation in Foster City, California. It prescribes very low doses of ketamine through telehealth and ships the medicine to patients every month, so there is no clinic to visit.

Approach

Joyous uses what it calls psycholytic doses, which it says are too low to cause a psychedelic experience. The medicine comes as lozenges that dissolve between cheek and lip over about 15 minutes. Patients begin on the lowest dose, answer daily text messages about how they feel, and have the dose adjusted from there. Courses, guided meditations and a patient community sit in an online portal, Be Joyous. Dr Bobbi Leben, a co-founder, is chief medical officer.

Who it is for

Joyous names anxiety, depression and PTSD among the conditions it treats, along with OCD, grief, chronic stress and performance anxiety. It sees its best candidates as people for whom therapy or standard medication was not enough. It is open only in certain US states.

Practical details

The flexible plan costs $159 a month and falls to $129 after three months; a three-month commitment costs $129 a month from the start. The price is the same at any dose and covers medication, provider appointments, the care and nurse team, and the portal. Insurance does not pay for it, but HSA and FSA cards are accepted.

Care and safety

Before prescribing, a licensed provider reviews each patient’s medical and psychiatric history and current medicines in a free video consultation. A telehealth check-in after 21 to 35 days decides whether a refill makes sense. Ketamine was approved by the FDA in 1970 as an anaesthetic; the lozenges Joyous uses are compounded and prescribed off-label for mental health. Joyous says patients can stay on antidepressants, and that its team plans with them how to stop safely.