Trying ketamine therapy for the first time brings up real questions, and often some nerves. That is normal. Knowing what happens at each step, from your first phone call through the days after treatment, tends to settle much of the worry. This walkthrough covers the full arc of a first visit at Nushama, so nothing about the day catches you off guard.
We approach ketamine as a catalyst, not a cure. The medicine can open a window for change, but preparation and integration are what help that change last. Below is what to expect, plainly explained, along with the safety steps that guide every journey.
What happens during your medical and psychiatric intake?
Your first visit is a conversation, not a treatment. Before anyone books an infusion, a clinician reviews your health history, current medications, past experiences with depression or trauma, and your goals for care. This psychiatric assessment is how we confirm that ketamine is a reasonable fit and, just as important, how we rule out reasons it might not be.
IV ketamine is a medication delivered intravenously, meaning directly into a vein, under medical supervision. Because it can raise blood pressure and heart rate, the intake includes a medical screening: blood pressure, cardiac history, and a review of conditions that call for extra caution, such as uncontrolled hypertension or certain psychiatric diagnoses. If something needs a closer look, we say so before moving forward.
You will also talk about logistics. Ketamine causes temporary changes in perception, so you cannot drive afterward, and you will arrange a ride home. Members often tell us the intake is the moment their nerves start to ease, because they finally have real answers instead of guesses. If you are exploring options for treatment-resistant depression, this is where a personalized plan begins to take shape.
How should you prepare before your first ketamine session?
Good ketamine session preparation happens in the days before you arrive, and most of it is gentle. Your body and mind both do better when you come in rested and settled.
In the week leading up to your visit:
- Sleep well and stay hydrated. Eat normal, healthy meals.
- Avoid alcohol, cannabis, and other recreational substances for a few days beforehand.
- Take time to reflect. Journaling, a walk, or quiet meditation can help you notice what you hope to explore.
- Follow any fasting guidance your care team gives you, usually a light stomach for a few hours before the infusion.
The mental side matters as much as the physical. Set and setting, meaning your mindset and your surroundings, shape the experience. That is why we spend time on intention setting: a short, unscripted conversation about what you hope to work through or release. An intention is not a goal to achieve during the session. It is more like a direction to hold loosely. Our guide to creating your set and setting walks through this in more detail, and your preparation coach helps you get ready in the days before.
What will you experience during the IV ketamine infusion?
The IV ketamine infusion experience follows a predictable arc: a calm arrival, a gradual onset, a peak that lasts most of the session, and a soft return to baseline. A typical session runs about 45 to 90 minutes including monitoring, and you are never alone for it.
Here is how the session usually unfolds:
- Settling in. A nurse checks your vitals and places a small IV line. You recline in a private room, often with an eye mask and headphones playing curated music. A brief grounding moment reconnects you with your intention.
- Onset. Within several minutes of the infusion starting, you may feel a gentle lift, a floating sensation, or a sense of stepping slightly back from your usual thoughts. This is dissociation, a temporary feeling of detachment from your body or surroundings. It is expected, and it passes.
- The journey. Over the next stretch, emotions, memories, or dreamlike imagery may surface. Some members find this deeply restful; others describe it as moving or emotional. There is no right way to experience it.
- Return. As the infusion ends, the effects fade over the following hour. Our medical team monitors you throughout and can adjust or stop the infusion at any point.
Two things set clinic-based IV care apart. First, the dose is titrated, meaning it is adjusted in real time based on how you respond, which gives clinicians precise control that at-home or intranasal formats cannot match. You can read more about that tradeoff in our comparison of IV versus intramuscular ketamine. Second, a trained team stays with you, so if the experience feels intense, someone is right there to help you feel safe.
What should you do in the 24 to 72 hours after treatment?
The days right after your infusion are when much of the real work happens, thanks to a period researchers call the neural plasticity window. Neural plasticity, also called neuroplasticity, is the brain’s ability to form new connections between neurons. Ketamine appears to accelerate this process.
Research from the National Institute of Mental Health found that a single dose of ketamine rapidly stimulates new synapse formation in the prefrontal cortex, working through the brain’s glutamate system rather than the serotonin pathway that older antidepressants target (NIMH, 2010). This is why relief can arrive within hours rather than weeks. During this window, the brain is more open to forming new patterns, which makes the days after treatment a genuine opportunity, not just recovery time.
To make the most of it:
- Keep your schedule light. Rest, hydrate, and avoid major stressors where you can.
- Journal or reflect on anything that surfaced during the session.
- Move gently. A walk in nature, light stretching, or time with people who feel safe can help.
- Meet with your integration coach to make sense of the experience.
This is where integration coaching becomes the difference between a striking experience and durable change. Integration is the practice of translating what came up during the session into changes you can carry into daily life.
How does Nushama’s support differ from at-home models?
The medicine is similar across providers; the container around it is not. That container, the screening, the in-person monitoring, and the structured support afterward, is where clinic-based care and telehealth-only models diverge most.
| Element | Nushama clinic-based care | Typical at-home model |
|---|---|---|
| Medical screening | In-depth psychiatric and cardiac assessment | Often a brief virtual questionnaire |
| Administration | IV, titrated in real time | Oral or nasal, fixed dose |
| Monitoring | Clinical team present throughout | Remote or a peer monitor |
| Integration | Coaching during the plasticity window | Varies, often self-guided |
IV delivery gives clinicians moment-to-moment control, which matters most for a first-time member who wants a predictable experience. And because a team is physically present, the setting itself, private, calm, and unhurried, becomes part of the treatment rather than an afterthought. This is the model behind Nushama’s physician-led program in Manhattan and Miami.
The evidence for this integrated approach is encouraging. A 2025 real-world study of 117 people with treatment-resistant PTSD, published in the Journal of Psychopharmacology, delivered IV ketamine in a setting built around preparation, integration, and sensory immersion. Average PTSD symptom scores fell from 52.54 to 28.78, with over 60% of participants reaching remission (MacConnel, Earleywine, and Radowitz, 2025, via PsyPost). The authors emphasize that the therapeutic environment, not the medicine alone, may drive much of the benefit. That finding sits at the center of how we work.
FAQs
Does the ketamine infusion hurt?
No. A nurse places a small IV line in your arm, which feels like a quick pinch, and numbing options are available. The infusion itself is painless, and you recline comfortably throughout the session.
Will I be unconscious or lose control during the session?
No. IV ketamine at therapeutic doses produces a dissociative, dreamlike state, but you remain conscious and can communicate with your care team. The dose is titrated and monitored, and the infusion can be paused or stopped at any time.
How many sessions will I need?
It varies by person and goal. Many protocols begin with a short series of infusions over a few weeks, followed by maintenance sessions as needed. Your care team builds a plan during intake and adjusts it based on how you respond.
Can I drive myself home afterward?
No. Because ketamine temporarily affects perception and coordination, you will need to arrange a ride home. Most members feel back to baseline within a few hours, but driving the same day is not safe.
Is ketamine therapy a cure?
Ketamine is a catalyst, not a cure. It may open a window for change, and emerging evidence suggests it can support relief from conditions like depression and PTSD. Preparation and integration are what help those gains last.
Taking the first step
A first ketamine session is less about the medicine and more about the care around it: a thorough intake, thoughtful preparation, real-time monitoring, and structured support during the days that follow. That is the arc we have walked through here, and it is the arc we design for every member.
If you are weighing your options and want clear answers tailored to your situation, speak with our care team. We will listen first, explain what to expect, and help you decide whether ketamine therapy is a good fit at your own pace.