If this is your first ketamine experience you are likely to be apprehensive. That’s normal.

I will meet with you before we get to the medication - review what to expect, make sure it’s safe to proceed, and go over informed consent. I may check your weight (for dosing of the medications;) you don’t have to see it if you don’t want to. I will check your blood pressure and pulse. If your pressure is somewhat elevated I may ask you to take a blood pressure drug (clonidine) before we get started. (If it’s very high I will cancel the session and re-schedule when your pressure is controlled.) If you are prone to nausea and vomiting I will give you a nausea medication (ondansetron, orally dissolving.)

Additionally, I will confirm that you have a driver. If you do not, unless you are staying within walking distance, I cannot proceed.

We will take a few minutes for relaxation and setting intentions. And the last thing before starting is to use the bathroom: it’s best not to have to get up during the session.

For the journey you sit in a very comfortable zero-gravity recliner. You will have noise-canceling headphones with a curated music track running both through the phones and ambiently in the room; using headphones is optional but recommended. An eye mask will keep the light out, and you will be offered a weighted blanket. The setting is designed to reduce outside sensory input except the soundtrack. Taking drugs recreationally, people experience the world around them, but with this approach there is nowhere to go but inside.

We will discuss your dose before we start. The first time I will start low, with a booster given about 10-20 minutes in if we both think it’s the right thing. For subcutaneous, the second dose can be SC or IM. And for IM treatment the dose is divided into 2 parts to bring you to a good level of effect for an appropriate period of time. Sometimes I may give a third shot.

During your journey I will remain in the room, as will a “co-sitter”, if present. (This is discussed later on the Safety page.) My job is to monitor for safety, and I may check your blood pressure during the journey. I may need to give you a shot to bring the pressure down if it’s getting dangerously high, but this is unlikely. And my other job is to help create an envelope of safety and healing.