Ketamine has shown antidepressant effects for more than two decades. Initial reports indicating ketamine’s rapid antidepressant effects came about in the 1990s. If you are considering ketamine, you may wonder what it might feel like. This blog post is to help you conceptualize what it may entail and put your mind at ease. Of course, due to the subjective nature of any mind-altering medication, no two people will share the same experience. The nuances of what you may feel are influenced by your past, mental health challenges, prior exposure to psychedelics, and many other factors.
You will receive a lower dose of ketamine initially, to ensure your comfort with the medication, before receiving a second dose (ten minutes after your first dose). Starting low and going slow is the best way to ensure you remain comfortable during the treatment. You can begin with a full therapeutic dose if you decide to do additional sessions in the future. The medication will be injected via the intramuscular (IM) route, which is similar to receiving a vaccine. Studies have shown that IM ketamine is comparable in efficacy to receiving a ketamine infusion but without needing to be hooked up to an intravenous catheter.
In the beginning, you may notice a sense of warmth spreading throughout your body, followed by a feeling of lightness or floating. Some people report feeling disoriented or confused, but this usually subsides after a few moments. As the experience progresses, you may notice a change in your thoughts and emotions. You might feel disconnected from your usual worries, and your mind may feel clear and uncluttered. Some patients describe this sensation as similar to meditating. As the experience ends, you may feel fatigued or disoriented for a few minutes, but this typically passes quickly. Most people report feeling calm after their ketamine session. A provider will remain with you during the entirety of your sessions to ensure you feel comfortable and supported.
The most common side effects of ketamine treatment are nausea, increased blood pressure and heart rate. Nausea can be managed by fasting three hours before receiving ketamine and treating residual symptoms with anti-nausea medication. Vital signs will be taken at your pre-procedure appointment and again before treatment begins. Pre-existing hypertension must be well controlled before being considered for ketamine treatment. Any increases in blood pressure during your session should be transient. Most people note a decreased blood pressure at the conclusion of their ketamine sessions due to ketamine having a calming, anxiety reducing effect on the mind and body.
Many patients ask if receiving ketamine might make them relive past trauma, and if so, will this experience retraumatize them. Typically, ketamine creates a detached state, which provides a space for introspection and self-exploration, allowing people to revisit traumatic memories without the overwhelming emotions commonly associated with them. In addition, most people describe feeling like an “observer” to their past experiences, which does not trigger an emotional response. A 2023 meta-analysis recently showed a combined treatment model of ketamine and psychotherapy is the most effective approach.
Overall, the experience of receiving ketamine can vary significantly from person to person. Some patients report feeling a sense of euphoria or even mystical experiences, while others may feel a sense of relaxation or relief from their symptoms of depression or anxiety. Post-treatment, many patients report a positive experience, substantial relief from their depressive symptoms, and an increased ability to connect with friends and family. Increased motivation and energy are also common. These benefits of repeated ketamine treatments, over several weeks, can last several months and often longer.
Ahuja, S., Brendle, M., Smart, L., Moore, C., Thielking, P., & Robison, R. (2022). Real-world depression, anxiety and safety outcomes of intramuscular ketamine treatment: a retrospective descriptive cohort study. BMC Psychiatry, 22(1), 1–11. https://doi-org.frontier.idm.oclc.org/10.1186/s12888-022-04268-5
Philipp-Muller, A. E., Stephenson, C. J., Moghimi, E., Shirazi, A. H., Milev, R., Vazquez, G., Reshetukha, T., & Alavi, N. (2023). Combining Ketamine and Psychotherapy for the Treatment of Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis. The Journal of Clinical Psychiatry, 84(2). https://doi-org.frontier.idm.oclc.org/10.4088/JCP.22br14564