Preparing for ketamine treatment involves a mix of physical, logistical, and mental steps, most of which happen in the days and hours before your appointment. The basics: you’ll need to fast, arrange a ride home, discuss your current medications with your provider, and give some thought to what you want from the experience. Here’s what to do and when.
Confirm You’re Medically Eligible
Before your first session, your provider will screen for conditions that make ketamine unsafe. Ketamine raises blood pressure, so it’s contraindicated if you have uncontrolled hypertension, a history of aortic dissection, aneurysms, or recent heart attack. It’s also avoided in people with schizophrenia because it can worsen psychotic symptoms. If you have a history of allergic reactions to ketamine, including anaphylaxis or angioedema, you won’t be a candidate.
Blood pressure monitoring is a standard part of every session. Readings are typically taken every 10 minutes during an infusion. Research on over 2,000 infusion sessions found that about 12.5% of patients experienced at least one episode of severe hypertension, and these spikes were more common during the first three treatments. If you have a history of high blood pressure, even if it’s currently managed, make sure your provider knows. They may want a recent reading from your primary care doctor before proceeding.
Talk to Your Provider About Medications
Certain medications can interact with ketamine or change how effective it is, so your provider will want a complete list of everything you take. Benzodiazepines (commonly prescribed for anxiety) are the most frequently flagged class because they may blunt ketamine’s therapeutic effects. Many clinics ask patients to skip their dose the morning of treatment, but don’t adjust anything on your own. Your provider will tell you exactly what to pause and when.
Lamotrigine, a mood stabilizer used for bipolar disorder, has gotten attention for possibly interfering with ketamine. The picture is mixed. In studies on healthy volunteers, lamotrigine reduced some of ketamine’s dissociative effects. But in studies on patients actually being treated for depression, lamotrigine didn’t appear to weaken ketamine’s antidepressant benefit. Your provider may or may not ask you to adjust it. The key step on your end is simply being transparent about every medication and supplement you’re taking so you can make the decision together.
Follow Fasting Instructions
Ketamine can cause nausea and vomiting, so clinics use fasting rules similar to those for minor surgical procedures. Memorial Sloan Kettering’s protocol is a common example: no solid food after midnight the night before, clear liquids only from midnight until two hours before treatment, then nothing by mouth at all in that final two-hour window.
Your specific clinic may have slightly different timing, especially if your appointment is in the afternoon. Follow whatever instructions they give you. The goal is an empty stomach so that if nausea hits, the risk of vomiting is low. If you take morning medications with a sip of water, ask whether that’s okay within the fasting window.
Set an Intention
Ketamine produces an altered state of consciousness, and how you approach that experience mentally can shape what you get out of it. Clinicians who work in ketamine-assisted psychotherapy often encourage patients to set an intention before the session. This isn’t a rigid goal or a specific outcome you’re trying to force. It’s more like a guiding question or theme you carry into the experience.
An intention might be broad (“I want to understand what’s keeping me stuck”) or specific (“I want to explore my relationship with anger”). It gives your mind something to orient around when the experience gets strange or overwhelming. Some people write their intention down on a notecard and read it just before the session starts. Others discuss it with their therapist in a preparation appointment. If your clinic doesn’t offer formal preparation sessions, spend 10 or 15 minutes the evening before reflecting on what brought you to this treatment and what you most want to shift.
Plan Your Day-of Logistics
You will not be able to drive yourself home. Ketamine causes dizziness, impaired coordination, and altered perception that can linger for hours after the session ends. Arrange for someone to pick you up or plan to use a car service. Some clinics require that a responsible adult accompany you at discharge, similar to outpatient surgery rules.
The infusion itself typically lasts 40 to 60 minutes, but plan to be at the clinic much longer. After the infusion stops, acute psychological effects like dissociation and a floating sensation generally fade within 30 to 45 minutes. The care team will then monitor you for roughly another 30 minutes before clearing you to leave. Add in check-in time and paperwork, and a single session can take two to three hours from arrival to departure.
Block off the rest of your day. Mild side effects like dizziness, nausea, and feeling off-balance can persist for several hours after you leave. Don’t schedule work, childcare duties, or anything demanding. Treat it like a recovery day.
What to Wear and Bring
Wear comfortable, loose-fitting clothes. You’ll be seated or reclined for over an hour with a blood pressure cuff cycling on your arm, so skip anything with tight sleeves. Many patients bring an eye mask and headphones with a pre-loaded playlist. Music with minimal lyrics and a calm, steady tempo is a common choice, as it helps anchor the experience without pulling your attention toward words. Some clinics provide these items, so ask ahead of time.
Leave valuables at home or in your car. Bring your ID, insurance card if applicable, and a water bottle for afterward. A journal can be useful too. Many people find it helpful to jot down thoughts, images, or feelings shortly after the session while the experience is still fresh.
Know What to Expect During Treatment
About 1 in 10 patients experience noticeable side effects during the infusion. The most common are nausea, a feeling of floating or being outside your body, and a temporary spike in blood pressure. None of these are dangerous in a monitored setting. If nausea or anxiety becomes uncomfortable, the clinical team can administer additional medications through your IV to manage it, or simply slow the infusion rate.
The dissociative effects are the part most people feel unprepared for. You may feel detached from your body, perceive time differently, or have vivid mental imagery. This is the medication working as expected, not a sign that something is wrong. Remembering this in advance helps. People who go in understanding that the strangeness is temporary and purposeful tend to move through it more easily than those caught off guard.
Plan for Integration Afterward
What you do in the hours and days after a session matters as much as the session itself. Ketamine triggers a window of heightened neuroplasticity, a period when your brain is more receptive to forming new thought patterns and connections. Research suggests this window lasts at least 24 hours and may extend days or even weeks.
If you’re working with a therapist, try to schedule an integration session within 24 hours of your ketamine treatment. This is when insights from the experience are most accessible and your brain is most primed to consolidate new perspectives. During integration, you’ll typically talk through what came up during the session, connect it to your broader therapeutic goals, and identify any shifts in how you’re thinking or feeling.
Even without a formal therapy appointment, you can support integration on your own. Journaling immediately after the session captures details that fade quickly. Gentle movement like a walk the next morning can help you process. Avoid alcohol, heavy social obligations, and screens for the rest of the treatment day. The goal is to give yourself space to sit with whatever emerged rather than rushing back into your routine.
Prepare for a Series, Not a Single Session
Most treatment protocols involve a series of infusions, often six sessions spread over two to three weeks for the initial phase. The first session is typically the most unpredictable in terms of side effects and emotional response. Blood pressure spikes, for instance, are most common during the first three infusions. By sessions four and five, most people have a clearer sense of what the experience feels like and how their body responds.
Keep a brief log after each session noting your mood, sleep, energy, and any side effects. This gives both you and your provider concrete data to track your response and adjust the treatment plan. Some people notice improvement after the first or second session, while others don’t feel a meaningful shift until later in the series. Having a record helps you see patterns you might otherwise miss.