What Patients Say About the Four Levels of Ketamine Experiences
Ketamine therapy has been increasingly used to treat conditions such as depression, anxiety, PTSD, and chronic pain. Users report a range of experiences during their sessions, which some describe in four main levels or “non-ordinary states of consciousness” (NOSC). These experiences can range from mild dissociation to ego-dissolving, transcendent states. We looked at the responses in this Reddit thread to see how patients react and talk about each of these levels.
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1. Empathogenic Experience
- Features: Patients in this state experience heightened relaxation and a sense of peace and comfort. Empathy, compassion, and warmth often accompany a dreamy, euphoric mindset with mild visual effects. Users report feeling connected to their bodies and more emotionally open, though the experience is usually gentle and non-dissociative.
- Dose: Low sub-psychedelic dose, similar to that used for anxiolysis or mild analgesia (0.25 mg/kg to 0.5 mg/kg IM, or 25-50 mg IM).
- Duration: Typically 45–60 minutes.
What Patients Say About It: Many patients describe this level as an “empathogenic” experience, where they feel deep connection, love, and peace. It’s considered a safe, welcoming entry point for those new to ketamine treatment. Patients may feel enhanced compassion and comfort, which can support healing without overwhelming dissociative effects.
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2. Out-of-Body Experience (OBE)
- Features: At this level, patients often experience complete detachment from their bodies, sometimes entering realms of mythological or symbolic consciousness. Users may report encounters with beings, visions of past lives, or vivid mental images. The ego is partially dissolved, making it easier to explore inner thoughts and feelings from a detached, almost otherworldly perspective.
- Dose: Medium psychedelic dose, used for mild conscious dissociative sedation (0.75 mg/kg – 1.5 mg/kg IM, or 75-125 mg IM).
- Duration: Typically 45–60 minutes.
What Patients Say About It: This state is often described as an “out-of-body experience.” Patients report feeling as though they’re observing their life and thoughts from an external vantage point, making it a popular level for trauma work or deep personal reflection. Some users describe meeting symbolic figures or experiencing intense emotions tied to past memories, providing opportunities for insight and emotional release.
3. Near-Death Experience (NDE)
- Features: The near-death experience is more intense and deeply dissociative, involving a full departure from the body and ego. Patients may feel as though they’re approaching physical and psychological death, experiencing a profound loss of identity. This state often includes reflections on life choices, self-judgment, and encounters with a sense of oneness or universal consciousness.
- Dose: High psychedelic dose, typically used for moderate to severe conscious dissociative sedation (2.0 mg/kg – 3.0 mg/kg IM, or 150-250 mg IM).
- Duration: Typically 45–60 minutes.
What Patients Say About It: Those who reach this level frequently report it as one of the most transformative yet challenging experiences. Many describe it as a “rebirth,” where they confront aspects of themselves in an intense way. This can involve reviewing one’s life choices or experiencing moral introspection. For some, this level is extremely therapeutic and provides lasting shifts in perspective, though it can be unsettling for those unprepared for such depth.
4. Ego-Dissolving Transcendental Experience (EDT)
- Features: The most profound of the ketamine experiences, this level involves complete dissolution of the boundaries between self and the external world. Patients may feel unified with the universe, experiencing a transcendental sense of sacredness and oneness with nature. All sense of individual identity and time-space perception fades away.
- Dose: While rare at lower doses (0.25 mg/kg – 0.5 mg/kg IM), it’s common at higher doses (2.0 mg/kg – 3.0 mg/kg IM, or 150-250 mg IM).
- Duration: Typically 45–60 minutes.
What Patients Say About It: At this level, patients often feel they’ve transcended the limitations of physical existence and identity. The experience is frequently described as deeply spiritual or mystical, leaving a lasting impression of unity with the cosmos. Some users feel as though they’ve reached a new level of consciousness that redefines their understanding of self, purpose, and reality. Though powerful, this level requires careful guidance and integration afterward due to its profound effects on the psyche.
Final Thoughts
These four levels of ketamine-induced states provide a framework for understanding the range of effects ketamine can have, from simple relaxation and empathy to full transcendental unity. Patients seeking specific therapeutic outcomes can work with their providers to tailor the dose and approach to their comfort level and readiness for introspection. Whether seeking relief from chronic pain, trauma, or existential exploration, ketamine’s versatility allows it to cater to diverse therapeutic needs, with each level offering unique insights and healing potential.
