This Is How A Ketamine Therapy Session Works

This Is How A Ketamine Therapy Session Works

Ketamine therapy clinics have been popping up all over the place, with plenty of them available within the U.S. But what does a ketamine therapy session actually include? How long does it last and how should you prepare? Here’s how a ketamine therapy session works.

Ketamine has a history of being a party drug… and an FDA-approved anaesthetic. But it is also gaining a reputation as a psychedelic substance that can help in treating a wide array of mental health issues. Ketamine therapy has shown some amazing results for PTSD, depression and anxiety to mood disorders, bipolarity, and even addiction. So it’s no wonder the treatment itself has gained such popularity. 

It’s important to note, though, that the FDA does not currently regulate ketamine therapy clinics. And it’s on you to dive deep into research and find the one that will uphold all safety procedures and protocols . That will make the sessions efficient and safe. That isn’t to say that there’s a lack of credible, available organizations, to provide professional, straightforward advice.

Looking for ketamine therapy? Click here to find top rated ketamine clinics near you

Speaking of ketamine treatment, a clinician will administer it in one of four ways:

  • Using a nasal spray called esketamine, which was FDA-approved in 2019 for those struggling with treatment-resistant depression
  • An IV treatment using racemic ketamine, which has yet to be FDA approved
  • Intramuscular injection
  • Lozenges


The nasal spray called Spravato is currently only available through a restricted distribution system. That system is the Risk Evaluation and Mitigation Strategy (REMS) developed by the FDA. And according to them, it “must be administered in a certified medical office where the health care provider can monitor the patient.”

The eligibility for using esketamine is also rigorously regulated and only those with a major depressive disorder may use it. You have to have tried at least two antidepressant treatments at adequate doses for an adequate duration. Potential patients also can’t have responded to treatment. And are considered to have treatment-resistant depression, and can therefore be a good candidate for the esketamine therapy.

Spravato comes with a warning of potential sedation and dissociation (difficulty with attention, judgment and thinking). So patients must be monitored by a health care provider for at least two hours after receiving the dose. The spray is also self-administered under the supervision of a health care provider in a certified doctor’s office or clinic. And it’s important to note that the spray cannot be taken home. 

After the two hours have passed, a doctor will evaluate you. That doctor gives them the green light to leave the office and go home. 

RELATED: Here’s what to know before microdosing for anxiety

How A Ketamine Therapy Session Works – IV Ketamine Therapy 

The FDA has not approved this type of therapy yet. (The FDA approves of ketamine as an anesthetic, but not as a therapeutic. (Yet.) So it’s hard to know exactly how different types of clinics administer it.


Ideally, you should be in the state of a minimum 3 hour fast before going in for your session as some of the known side effects include nausea and vomiting. Having food in your stomach can therefore make these side effects much worse. 

Another important thing to keep in mind before your ketamine therapy session is to avoid having any other substances in your bloodstream at the time. This includes alcohol, which can cause cardiovascular problems, breathing issues, and even death, and caffeine, which can cause overstimulation and worsening of the side effects. 

Looking for ketamine therapy? Click here to find top rated ketamine clinics near you

Get Your Set Right

It’s also good to mentally prepare yourself for the session and bring yourself to a calm state. You can do this through meditation, mindfulness practice, or any other form of self-care that works for you. Ketamine therapy side effects can range from mild to severe. Getting yourself in a positive state of mind can definitely improve your overall experience. 

Talking about ketamine therapy with your partner, friend, or family member may also be a good idea. As emotional support can play a huge role in your experience. You will also need someone to come with you or at least pick you up. They will not allow you to go home by yourself.

RELATED: Here’s How To Find The Best Ketamine Therapy Clinic

If talking to someone close to you seems daunting, consider talk therapy. This is when you discuss your motivations, desires, and fears with a professional. You can go over everything that might be bothering you or you’re afraid of. As well as all the possible side effects. If you’re considering ketamine therapy, chances are you are already talking to a professional on a regular basis. If so, don’t forget to share this information with them. 


The usual standard protocol for ketamine IV infusions is 6 infusions over the course of two weeks. With each session lasting 45 minutes to an hour.

(The nasal spray session only happens once and you’re free to go after the few hours have passed.)

RELATED: Is Ketamine Therapy Right For You? Here’s What To Know

How A Ketamine Therapy Session Works – The Process

Upon your first visit, a psychiatry team will assess and evaluate you. If you’re not, then avoid that clinic. They should do this through a comprehensive mental health screening. You should also receive a medical and physical exam to ensure you’re the right candidate for ketamine IV therapy. 

You will meet with your anesthesia care providers on the day of the session. They will walk you through the whole process. And they will be there throughout its entirety, controlling and overseeing every step. 

They will seat you in a comfortable chair in a relaxing setting and hook you up to an IV. You will usually wear headphones so you can listen to relaxing music. Depending on the clinic, the infusion time can vary from 45-60 minutes. But have no fear – the anesthesia care provider will be there with you the entire time. 

They will likely transfer you to a spa-like setting after the IV session is complete. They will then assess you before allowing you to go home. In the following days, you will hopefully begin to feel less stressed. And your mood will hopefully become much improved. But pay attention to the aforementioned side effects. And call your healthcare provider as soon as you start experiencing them, if you do. 

Clinic spotlight: Northwest Ketamine Clinics – Seattle, Washington

In Conclusion – How A Ketamine Therapy Session Works

With ketamine, these two options are currently the only ones you can try with any guarantee of safety and control. Are you struggling with depression, anxiety, PTSD or other mental health issues? If so, talk to your doctor and discuss potential therapy treatment. 

RELATED: How Much Is Ketamine Therapy, And How Can You Pay?

Karla Tafra

View all posts by Karla Tafra

Karla is a freelance writer, yoga teacher and nutritionist who's been writing about nutrition, fitness, yoga, mindfulness, and overall health and wellness topics for over seven years. She's written for numerous publications such as Healthline, Livesavvy,, Well + Good, and many others, sharing her love of storytelling and educating. She loves talking about superfoods and another amazing plant powers that people can benefit from if they learn how to use it properly. Her passion lies in helping others not only eat healthier meals but implement good eating habits, find a great relationship with food & achieve a balanced lifestyle. She believes that the only diet and lifestyle that's worth creating is the one you can stick to, so she aims to find what that means for each and every individual. Teaching WHY we eat, and not only WHAT we eat, is the premise of her approach.

Dr. Ben Medrano

This post was medically approved by Dr. Ben Medrano

Dr. Ben Medrano is a board certified psychiatrist specializing in Integrative Psychiatry, Ketamine Assisted Therapy and Psychedelic Harm Reduction and Integration. He received his MD from the University of Colorado School of Medicine with additional training in the Urban Underserved Track (CU-UNITE). Dr. Medrano is most known for his work with ketamine assisted therapy and is the former Senior Vice President and US Medical Director of Field Trip Health - the largest in-office ketamine assisted therapy practice to date. He continues to sponsor Field Trip clinics as a local medical director at multiple sites on the East Coast allowing him to further the field of psychedelic assisted therapy and research.

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