If you’re considering ketamine therapy, know that the protocol will depend on the individual clinic or company. We’re using Neomedicine Institute as an illustrative example of intravenous ketamine, and patient experiences at other providers may vary.
Before
You’ll have a consultation, which includes a screening, which may include a blood pressure check and a look at your psychiatric history, to make sure that ketamine may be safe and effective for your goals. Ideally, you will be connected with a therapist to speak about what you hope to get out of ketamine treatment. Be open about your struggles, your coping mechanisms, whether you’ve tried therapy before, and what has worked and what hasn’t, says Liliana Uribe, PhD, a cognitive behavioral therapist who specializes in ketamine-assisted psychotherapy at Neomedicine Institute.
You may also be given preparation instructions, such as whether and how to fast beforehand, when to schedule transportation, and what expectations to have going into your session.
At your ketamine treatment appointment, you will be prepped appropriately (you may be weighed to determine dosage; if you’re receiving it intravenously, an IV will be started). You will sit or lie down in a room in a comfortable position with an eye mask to reduce light stimulation and headphones to either add supportive music or to cancel or reduce noise from the surrounding environment.
It’s normal to be nervous during your first appointment. “A big thing I’ve seen is an inability to let go. We have an issue with wanting to control every aspect of our environment, and we feel uneasy when something doesn’t go as planned or expected,” says Dr. Uribe. Discuss with a practitioner ahead of time about a sign you can give if you’re particularly nervous during the treatment. (Like a thumbs up or down, for example.)
During
Duration will differ depending on where you go and whether you’re taking the drug orally or doing an infusion. De La Hoz’s ketamine infusion sessions are 40 minutes long. In some instances, in addition to routine observation, ketamine will be given to you under medical supervision in which your vital signs are monitored.
You’ll likely need multiple ketamine sessions. “Ketamine has a cumulative effect,” says De La Hoz. The number of ketamine sessions needed will vary. Based on his own clinical experience, De La Hoz says, six sessions are typically needed before he understands the full spectrum of a patient’s response — and whether more therapy is necessary.
After
After the ketamine is administered, you’ll have the opportunity to recover. You should be monitored for any adverse reactions, and the practitioner should ensure you’re safe to go home. If you are using at-home ketamine, make sure you follow the aftercare directions. If you’re at a clinic, you will need someone to drive you home. Do not drink alcohol after your session.
Uribe suggests seeing treatment as a process. “Use the first session as discovery, and then try to surrender to the experience. After two or three sessions, people are typically more relaxed and open to let go and let the experience take them where it will,” Uribe says.
Ideally, you have integration sessions. These are psychotherapy appointments with a licensed therapist who can talk to you about what you experienced during your ketamine session. Though not all companies require this, experts say this is an integral part of the process and is needed for best results. It may be useful to take time off after the session to recover and process your emotions.
After a predetermined series of sessions, you’ll talk with the referring doctor, treatment team, and therapist about what you may need in the future. “Some patients do a maintenance program, and some do not need it. But most patients continue psychotherapy [with the clinic or one’s own therapist],” says De La Hoz.