Question 1

- question: "How does a ketamine infusion session work?

Accepted Answer

During an intravenous ketamine infusion, you will sit or recline in a comfortable chair in a monitored clinical setting. A nurse or clinician will place a small IV catheter, usually in your arm or hand. The ketamine is delivered at a [sub-anesthetic dose](/dosing/sub-anesthetic-dose-ranges/), typically 0.5 mg/kg over 40 minutes. Throughout the infusion, your blood pressure, heart rate, and oxygen saturation are monitored. Many patients experience a mild dissociative state, which may include altered perception, floating sensations, or visual changes. After the infusion ends, you will remain in the clinic for a 30 to 60 minute observation period before being discharged with a designated driver.

Question 2

How should I prepare for a ketamine treatment session?

Accepted Answer

Most providers recommend fasting for four to six hours before an intravenous infusion to reduce the risk of nausea, which is a common side effect. Continue taking your regular medications unless your provider specifically instructs otherwise. For a comprehensive preparation checklist, see our guide on [preparing for ketamine therapy](/clinical/preparing-for-ketamine-therapy/). Wear comfortable clothing and arrange for someone to drive you home, as you should not drive for at least several hours after treatment. Avoid alcohol and recreational substances for at least 24 hours beforehand. Some patients find it helpful to set an intention for the session and bring headphones with calming music. Stay well hydrated in the day leading up to treatment, stopping fluid intake according to fasting guidelines.

Question 3

How long does each ketamine treatment session take?

Accepted Answer

The total time commitment depends on the route of administration. For intravenous infusions, the actual infusion lasts approximately 40 minutes, but plan for a total visit of two to three hours including check-in, vital sign monitoring, the infusion itself, and the post-infusion observation period. Intranasal esketamine (Spravato) sessions require a two-hour monitoring period after administration. Sublingual ketamine troches dissolve over 15 to 20 minutes, with the overall experience lasting one to two hours. At-home oral ketamine sessions prescribed via telehealth typically involve a one to two hour experience. Regardless of the route, most patients feel ready to resume normal activities the following day.

Question 4

How many ketamine sessions will I need?

Accepted Answer

The standard initial protocol for intravenous ketamine involves six infusions administered over two to three weeks. This induction phase is designed to build a cumulative therapeutic effect. Research published in the American Journal of Psychiatry shows that response rates improve with successive infusions, with some patients not responding until the fourth, fifth, or sixth session. After the initial series, maintenance infusions are typically scheduled based on individual response, ranging from every two weeks to every few months. Some patients achieve sustained remission with periodic booster treatments, while others may need more frequent sessions to maintain benefits.

Question 5

What does ketamine feel like during the session?

Accepted Answer

At sub-anesthetic doses used for psychiatric treatment, ketamine produces a mild to moderate dissociative experience. Patients commonly report feeling a sense of floating, detachment from their body, or altered perception of time and space. Some experience visual phenomena such as shifting colors or patterns. Emotional responses vary widely, with some patients feeling deeply relaxed or euphoric while others may experience temporary anxiety or sadness. The dissociative effects typically peak around 15 to 20 minutes into an intravenous infusion and resolve within 15 to 30 minutes after the infusion ends. Most patients describe the experience as tolerable and often interesting or insightful.

Question 6

What happens after a ketamine session?

Accepted Answer

Immediately after the session, you will remain at the clinic for monitoring until the acute effects subside, usually 30 to 60 minutes for IV infusions. You may feel groggy, slightly disoriented, or mildly euphoric during this recovery period. A designated driver must take you home. For the remainder of the day, avoid driving, operating heavy machinery, making important decisions, or signing legal documents. Mild side effects like nausea, headache, or fatigue may persist for a few hours. Many providers recommend journaling or reflecting on your experience, as some patients report meaningful psychological insights during treatment. Normal activities can typically resume the next day.

Question 7

How often do I need maintenance treatments?

Accepted Answer

Maintenance frequency is highly individualized and depends on how long the antidepressant effects persist after your initial series. Some patients maintain improvement with a single booster infusion every four to eight weeks, while others may need treatments every two to three weeks. Research from Massachusetts General Hospital suggests that the average duration of response after a single infusion is about two to three weeks, though this varies considerably. Your provider will work with you to establish the optimal schedule, often starting with more frequent maintenance sessions and gradually extending the interval. If symptoms return, the schedule can be adjusted accordingly.

Question 8

Can ketamine therapy be combined with talk therapy?

Accepted Answer

Yes, and many clinicians encourage it. Ketamine-assisted psychotherapy (KAP) is a growing treatment model where psychotherapy is integrated with ketamine sessions. The neuroplasticity window that ketamine opens, characterized by increased brain-derived neurotrophic factor (BDNF) and enhanced synaptic connectivity, may make patients more receptive to therapeutic insights in the hours and days following treatment. Some therapists conduct sessions during the ketamine experience itself, while others schedule therapy within 24 to 48 hours after treatment. Studies published in the Journal of Psychopharmacology suggest that combining ketamine with psychotherapy may produce more durable antidepressant effects than ketamine alone. Learn more about [integration therapy after ketamine](/protocols/ketamine-integration-therapy/).

The Ketamine Treatment Process

Frequently Asked Questions

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