Ketamine therapy has emerged as a promising intervention for severe depression and other mental health conditions when traditional treatments fall short. Unlike conventional medications that might take weeks to take effect, ketamine can sometimes lift mood in a matter of hours. However, proper ketamine therapy prep is crucial to ensure a safe, comfortable, and practical session. This article provides a technical but accessible overview of what ketamine therapy involves and offers comprehensive guidance on how to prepare before you begin.
Why Ketamine Therapy for Depression and Anxiety?
Ketamine’s reputation in mental health comes from its remarkable results in hard-to-treat cases. It is often considered when other depression treatments (like SSRIs or talk therapy) have failed to provide relief. Research shows that a single low-dose infusion of ketamine can begin alleviating depressive symptoms within about an hour, and over 70% of patients with treatment-resistant depression experience significant improvement after a short series of infusions. This rapid action is a stark contrast to most antidepressants, which typically require weeks of consistent use before patients feel a difference. Ketamine’s mechanism is unique: it acts on the brain’s glutamate system to enhance neuroplasticity, essentially helping the brain form new connections and “reset” patterns that underlie mood disorders. This pharmacological profile may explain why ketamine can provide quick relief and also benefit patients who haven’t responded to anything else.
Another reason this therapy is generating excitement is its potential to help with severe anxiety and PTSD. Anxiety treatment infusions using ketamine can rapidly reduce symptoms in people with generalized anxiety or social anxiety who are not improving with conventional anti-anxiety medications. It’s important to note that ketamine for psychiatric use is done at sub-anesthetic doses under careful supervision. Patients do not get the full anesthesia experience, but rather a mild dissociative state that can facilitate therapeutic breakthroughs. All of these factors make ketamine a powerful ketamine therapy treatment option in the psychiatric toolkit when used appropriately. Of course, it’s not a first-line therapy, and it isn’t a permanent “cure”; most often, ketamine is one component of a broader treatment plan for holistic treatment for anxiety and depression that includes therapy and lifestyle changes.
Understanding Ketamine Treatment Options and Formats
It helps to know the different alternative therapies for depression available. Ketamine can be administered through a few routes, and the setting can vary from medical clinics to specialized wellness centers.
- IV Infusion for Mental Health: This is the standard in most ketamine therapy clinics. An IV line is placed in your arm, and a diluted ketamine solution is infused slowly by pump. You’ll typically be seated in a recliner or lying down, with vital signs monitored throughout. The infusion typically lasts between 40 and 60 minutes. IV infusions allow precise control of dosing and are done under direct medical supervision for safety.
- Intramuscular (IM) Injections: Some providers use IM shots of ketamine, injected into a large muscle. IM sessions might be slightly shorter and don’t require an IV line, but the effects can come on more quickly and intensely since the full dose is delivered at once. Similar to IV, this procedure is performed in a clinic setting with continuous monitoring.
- Nasal Spray: Esketamine (brand name Spravato) is an FDA-approved nasal spray form of ketamine prescribed for treatment-resistant depression. It must be administered in a certified medical office or clinic under supervision. Patients self-administer the spray into their nostrils in the presence of a healthcare provider, then relax in the clinic for at least two hours of observation. Nasal ketamine treatments are typically done once or twice a week during an initial phase, then spaced out in maintenance. This option is often pursued when IV infusions are not accessible or for patients who prefer a less invasive route. However, it still requires clinic visits and monitoring due to ketamine’s potent effects.
- Sublingual Lozenges: Some integrative practices provide ketamine in the form of lozenges or troches that dissolve under the tongue. These ketamine treatment options are usually off-label and used as part of at-home adjunct therapy or to maintain gains between infusions. The dose in lozenge form is lower, and absorption is slower and less predictable than an IV, so the effects are milder. If lozenges are prescribed, the clinic will provide you with detailed guidelines on how and when to take them, and you may be required to attend periodic check-ins.
- Other Formats: In a research or hospital setting, ketamine might also be given via intranasal, oral tablets, or subcutaneous injections, but these are less common for outpatient therapy. Researchers continue to explore new delivery methods.
No matter the format, ketamine therapy should take place under professional supervision. You’ll want to be in a calm, safe setting with a trained provider present or nearby. Many clinics create a soothing atmosphere with low lighting, blankets, and eye masks, as well as calming music, to enhance the therapeutic experience. Ketamine treatment centers also vary in whether they incorporate psychotherapy during or after the ketamine administration.
Finding and Choosing a Trusted Ketamine Provider
With the surge in interest, specialized ketamine therapy clinics have been popping up across the country. Do your homework when trying to find ketamine providers you can trust. Here are some key factors and questions to consider:
- Medical Expertise: Ensure the clinic has licensed healthcare professionals with relevant experience. Ideally, the infusions are conducted by or under the oversight of a physician or a certified nurse anesthetist. Clinics associated with hospitals or academic centers tend to have strict protocols. Don’t hesitate to ask what medical training the staff has and who will be present during your ketamine sessions.
- Screening and Evaluation: A reputable provider will require an initial comprehensive consultation. They should review your medical history, current medications, and mental health status to confirm you’re a suitable candidate. Avoid places that seem willing to skip a thorough screening or that promise ketamine to anyone without proper evaluation. You want a personalized treatment plan, not a one-size-fits-all approach.
- Safety and Monitoring: Ask about the safety measures in place. Is continuous monitoring provided during the infusion? Are there emergency medications and equipment on hand? Also, what is the protocol if you become very anxious or distressed during the session – will a clinician be immediately available to assist you? Peace of mind comes from knowing that the clinic is prepared for any contingency.
- Therapeutic Support: Consider what psychological support is offered. The best ketamine therapy clinics integrate mental health care, such as having a therapist facilitate your session or providing integration therapy afterward. Even if they don’t offer therapy in-house, good clinics will coordinate with your existing therapist or refer you to resources to help you process your experiences. Ketamine often brings up profound insights or emotions, so plan for therapy or counseling as part of your aftercare.
- Comfort and Setting: Visit the clinic if possible. The environment should feel calm, private, and comfortable. This really matters because set and setting can influence your experience. You don’t want to receive ketamine in a chaotic or non-private setting where you might feel uneasy. Look for a clinic that prioritizes patient comfort.
- Costs and Scheduling: Ketamine treatment is often out-of-pocket. Obtain a clear breakdown of the cost per session and the recommended number of sessions. Reputable centers will be transparent about pricing. Also, ask about scheduling flexibility – will they accommodate your needs for appointment times? Do they offer any financing options if needed? Practical details like these can reduce stress down the line.
Once you’re satisfied with a provider’s credentials and approach, you’ll usually have an initial appointment to develop your treatment plan. Before you officially book a ketamine session, the clinic’s physician or team should walk you through the process, discuss risks and benefits, and obtain informed consent. This is a good time to bring up any questions or concerns you have. You want a provider who is responsive, patient, and open about the process. Feeling comfortable with the team is an integral part of mentally preparing for the journey.
Physical Ketamine Treatment Preparation: How to Get Your Body Ready
When it comes to ketamine session tips, tending to your physical well-being can make a big difference in how smoothly your session goes. The clinic will give you specific instructions, but here we outline the standard guidelines for the days leading up to your ketamine appointment:
- Fasting: Avoid eating for about 4 hours before your appointment, and do not drink anything for 2 hours prior. Having an empty stomach reduces the risk of nausea or vomiting during the ketamine infusion. Ketamine can sometimes cause stomach upset, so following these fasting rules is essential for your comfort and safety. If your session is in the morning, you may be advised to skip breakfast.
- Medications: Review all your current medications with your ketamine doctor well before the session. Some drugs may need to be paused or adjusted. In particular, many clinics ask patients to temporarily hold benzodiazepines for a day or two leading up to ketamine treatment, because benzos can blunt the psychedelic and antidepressant effects of ketamine. Similarly, certain mood stabilizers like lamotrigine might reduce ketamine’s effectiveness. Do not stop any prescription on your own, but do follow your provider’s guidance on when to skip a dose for ketamine. Typically, you’ll continue most routine medications as usual, but it’s critical that the ketamine team knows everything you’re taking.
- No Alcohol or Drugs: Refrain from drinking alcohol or using recreational drugs for at least 24 hours before your session. Substances like alcohol, cannabis, or opioids can interact unpredictably with ketamine or add strain to your system. Plus, going in with a clear head will help you get the most out of the ketamine experience. If you show up intoxicated, reputable clinics will reschedule you for safety reasons.
- Sleep and Hydration: Prioritize rest the night before. It’s normal to feel some nerves, but try to get as much sleep as possible, as being well-rested can enhance your ability to handle the psychoactive effects. If needed, practice good sleep hygiene: avoid screens late at night, consider a light relaxation exercise, and go to bed early. Along with getting enough sleep, make sure to stay hydrated on the day of your infusion by drinking water in the morning. Good hydration can help regulate your blood pressure and vein access for the IV. Just don’t chug a ton of water right before, since you’ll have a period you shouldn’t drink; sip steadily in the hours earlier.
- Comfortable Clothing: Soft pants like sweatpants or yoga pants, and layers on top are great choices. Clinics often provide a blanket, but you can bring your own if it makes you feel more at home. Avoid tight collars or anything that could feel restrictive when you’re reclining for an hour. Also, leave expensive jewelry or accessories at home, as you won’t need them, and you want to be physically at ease.
- Getting There and Back: Arrange for a driver or escort to take you home after the session. This is non-negotiable. Clinics will not let you drive yourself after ketamine, as your reaction time and coordination can be impaired for several hours. Have a trusted friend or family member pick you up, or use a ride service. Plan this in advance so you’re not scrambling on the day of. Likewise, consider having someone accompany you to the clinic if that makes you feel more secure, even if they can’t be in the treatment room.
- Other Logistics: Try to free up the rest of your day after the infusion. You’ll want to go home and relax, rather than heading straight back to work or other obligations. Clear your schedule if possible. If you have child-care or pet-care responsibilities, arrange coverage for that day.
By handling these practical steps, you set the stage for a smoother ketamine experience. Being physically prepared means there are fewer potential hiccups to worry about, allowing you to focus on the therapeutic process itself.
After the Session: Recovery and Integration
Once you get home, plan on taking it easy for the remainder of the day. Ketamine’s acute effects wear off quickly, but you might still feel a bit tired, unsteady, or emotionally raw for a few hours. This is normal. Listen to your body and mind. Ideally, have a quiet, comfortable space arranged at home where you can relax. Some people like to nap after a session; others prefer to journal or simply enjoy a peaceful activity, such as sitting on the couch with soft music. You may notice some new thoughts or emotions bubbling up in this post-ketamine afterglow. It can be insightful to jot down a few notes about what you experienced during the session, or any realizations you’re having. These notes can help you remember key points later. If you feel up to it and want some human contact, you might call a supportive friend to let them know you’re okay and perhaps share a bit about how it went.
The concept of “integration” refers to applying the insights or psychological shifts gained from the ketamine journey to your daily life and ongoing therapy. This is where the real therapeutic value often solidifies. In the days after your session, make time for self-reflection. It’s also wise to continue or resume therapy as soon as possible after the session. If you don’t have a therapist, even talking it through with a support group or a close friend who is a good listener can be valuable. The idea is to extract meaning and actionable insights.
In addition to psychological integration, maintain those healthy habits that support mental health. Continue prioritizing good sleep, eating well, and gentle exercise in the week after treatment. This helps your brain solidify the positive neurochemical changes from ketamine. If the ketamine session lifted your mood or anxiety, use that window of relief to implement positive activities to reinforce feeling better. In line with this integrative approach, some providers – including ModMeds Life – incorporate ketamine therapy as part of a broader wellness program, combining the medical treatment with counseling, mindfulness practices, and other complementary therapies. This kind of comprehensive, mental prep for ketamine ensures that the gains are reinforced by overall improvements in one’s psychological and physical well-being.
Preparation might require a bit of effort and planning, but it pays off in helping you feel more confident and secure as you step into an unfamiliar treatment. With the proper prep, ketamine therapy can be a transformative and positive experience, opening the door to relief and new perspectives for those struggling with depression or anxiety. Good luck, and take care on your path to wellness!
Sources
- Healthline – “Ketamine for Anxiety: How it Works, Research, How to Try It.” (Reviewed 2022)
- Anxiety & Depression Association of America – “Ketamine: A Rising Star in Mental Health Treatment,” Allison Wells, MD (April 25, 2024)
- Pacific Neuroscience Institute – “Preparing for Ketamine-Assisted Psychotherapy,” Zara Jethani (April 10, 2024)
- Washington Interventional Psychiatry – “What Should You Do Before and After a Ketamine Infusion?” Navin Reddy, MD (April 23, 2025)
- Harvard Health Publishing – “Ketamine for treatment-resistant depression: When and where is it safe?” Michael D. Craig Miller, MD (August 9, 2022)