What to Expect at Your First Ketamine Session

Starting ketamine therapy can feel daunting, especially when you are unsure what the experience will be like. Here is a comprehensive guide to what typically happens at your first ketamine session.

Before Your Appointment

Your clinic will provide specific preparation instructions. Standard guidance includes:

• Fast for 4-6 hours before an IV infusion (reduces nausea risk)
• Avoid alcohol for at least 24 hours beforehand
• Arrange transportation home -- you cannot drive after a session
• Wear comfortable, loose clothing
• Avoid stimulants (caffeine) on the day of treatment
• Consider setting a loose intention or focus for your session

At the Clinic

You will check in, have vital signs taken (blood pressure, heart rate), and be settled into a comfortable recliner in a calm, private or semi-private room. Most clinics create a relaxing environment with dimmable lighting, eye shades, headphones and curated music, and blankets and pillows. For IV infusions, a nurse will place an IV line in your arm or hand.

The Infusion Experience

Within 5-10 minutes of starting the infusion, you will begin to feel effects. Common experiences include:

• Dissociation: A sense of separation from your body or surroundings
• Altered time perception: Time may feel stretched, compressed, or irrelevant
• Visual effects: Enhanced colors, closed-eye visuals or imagery
• Floating sensation: Many feel weightless or floating
• Emotional release: Catharsis, relief, or occasionally difficult emotions
• Dream-like states: Hypnagogic imagery, memories, or symbolic experiences

After the Session

You will rest for 30-60 minutes as the effects wear off before being evaluated for discharge. You may feel groggy, emotionally sensitive, or lighter than usual. Plan for a rest day. Avoid driving, major decisions, and alcohol for at least 24 hours after the session.

Integration

The therapeutic work of ketamine happens not just during the session, but in the days and weeks afterward as your brain forms new neural connections. Support this process through journaling about your experience, therapy sessions, mindfulness or meditation, gentle exercise, and open communication with your care team about what you experienced and any questions that arise.