If you’re considering ketamine therapy, know that the protocol will depend on the individual clinic or company. We’re using Neomedicine Institute as an illustrative example, and patient experiences at other providers may vary.BeforeYou’ll have a consultation, which includes a screening to make sure that ketamine may be safe and effective for your goals. Ideally, you will be connected with a therapist to speak about what you hope to get out of ketamine treatment. Be open about your struggles, your coping mechanisms, whether you’ve tried therapy before and what has worked and what hasn’t, says Liliana Uribe, PhD, a cognitive behavioral therapist who specializes in ketamine-assisted psychotherapy at Neomedicine Institute.At your ketamine treatment appointment, you will be prepped appropriately (you may be weighed to determine dosage; if you’re receiving it intravenously, an IV will be started). You will lie down in a room in a comfortable position with an eye mask and headphones to decrease noise and light from your surrounding environment.It’s normal to be nervous during your first appointment. “A big thing I’ve seen is an inability to let go. We have an issue with wanting to control every aspect of our environment, and we feel uneasy when something doesn’t go as planned or expected,” says Dr. Uribe. Discuss with a practitioner ahead of time about a sign you can give if you’re particularly nervous during the treatment. (Like a thumbs up or down, for example.)DuringDuration will differ depending on where you go and whether you’re taking the drug orally or doing an infusion. De La Hoz’s ketamine infusion sessions are 40 minutes long. In some instances, in addition to routine observation, ketamine will be given to you under medical supervision where your vitals are monitored.Being “under” in ketamine is being in a wake state but resting, says Uribe. This is a dissociative state where you feel detachment from your body and your environment, per a study published in Anesthesiology in November 2020. “You’re not paralyzed, but you feel a weight over you that makes it difficult to move around and speak,” says Uribe. If you are getting an infusion, the clinician can shut off the infusion at any time if you are uncomfortable, which will bring you back to consciousness.You’ll likely need multiple ketamine sessions. “Ketamine has a cumulative effect,” says De La Hoz. The number of ketamine sessions needed will vary. Based on his own clinical experience, De La Hoz says, six sessions are typically needed before he understands the full spectrum of a patient’s response — and whether more therapy is necessary.AfterAfter the ketamine is administered, you’ll have the opportunity to recover. You should be monitored for any adverse reactions and the practitioner should ensure you’re safe to go home. If you are using at-home ketamine, make sure you follow the aftercare directions. At a clinic? You will need someone to drive you home. Do not drink alcohol after your session.Uribe suggests seeing treatment as a process. “Use the first session as discovery, and then try to surrender to the experience. After two or three sessions, people are typically more relaxed and open to let go and let the experience take them where it will,” Uribe says.Ideally, you have integration sessions. These are psychotherapy appointments with a licensed therapist who can talk to you about what you experienced during your ketamine session. Though not all companies require this, experts say this is an integral part of the process and is needed for best results.Following a predetermined series of sessions, you’ll then talk about what you may need in the future. “Some patients do a maintenance program, and some do not need it. But most patients continue psychotherapy [with the clinic or one’s own therapist],” says De La Hoz.