Preparation
You will get the most out of your journey if you prepare.
I ask you to take care of yourself in ways that may seem difficult, may be really foreign or uncomfortable. In the days preceding the journey you need to abstain from alcohol, cannabis, and other mind-altering substances. (The reality is that cannabis keeps ketamine from creating neuroplasticity, and alcohol, being a neurotoxin, will prevent new synapses from forming.) Please do your best to get sleep. Put aside whatever work you can for a few days. Take time for exercise, for nature, for meditation or prayer or whatever spiritual practice you do. Eat as healthily as you can.
It also helps to turn off the TV and other screens. You avoid putting poison into your body; think of most television (especially news channels) and Internet as poison for the mind.
Read spiritual texts, read poetry. Journaling is helpful. Receiving a massage or energy work can help relax and focus. Ecstatic dance, exercise, yoga. The list goes on.
Again, the important thing is that you try to go to a place of readiness, and that you keep toxins - both mental and physical - out of your system.
The night before your journey, try to get a good night’s sleep. And you need an empty stomach for the journey, at least 2 hours since eating or drinking. If you eat before the journey (like breakfast for an afternoon session) keep it light.
Medications
Some medications will interfere with ketamine’s effectiveness. In conjunction with your prescriber, I may ask you to taper down or hold some medications:
• Benzodiazepines, like alprazolam (Xanax,) diazepam (Valium,) lorazepam (Ativan.)These will reduce the effectiveness of ketamine. If you’ve been taking them regularly for any length of time it’s not safe to just do without, but I may ask you to reduce your dose, both short-term before the journey and longer-term for later ketamine work.
• Opioids (narcotics.) They will definitely interfere with ketamine’s effects in the brain. I will likely ask you to taper down or off narcotics before the journey.
• Cannabis. Cannabis gets in the way of ketamine’s effectiveness. In general cannabis works to keep people locked into their emotional pain even as it seems to help the pain and anxiety short-term. Reducing, or getting off, cannabis will help your therapy process considerably, and it will help ketamine to be effective.
• Lamotrigine. Lamotrigine is an extremely effective anti-depressant. It can block some of ketamine’s potency, and I may ask you to hold it for one or two days before ketamine. It is important not to be off of lamotrigine for more than 3 days, or you will need to start back at the lowest dose like when you first went on it.
Most other medications are okay to stay on during ketamine treatment, including antidepressants. Check with your doctor before changing or stopping any medication you are taking