Ketamine Therapy: What to Expect Before, During & After

Ketamine therapy can feel daunting, especially when you're trying it for the first time. What does it actually feel like during a session? How will your body react? Will you lose control? These questions are normal when considering a treatment that works so differently from traditional antidepressants.

This guide walks you through the complete experience, from your initial screening call to your recovery in the hours after treatment. You'll learn exactly what happens at each stage, what sensations to expect, and how Innerwell's clinical team supports you throughout the process.

By the end, you'll understand how ketamine therapy works at sub-anesthetic doses to promote new neural pathways in the brain's mood circuits, often creating rapid mood improvements within hours. More importantly, you'll know what to expect so you can approach your first session with confidence instead of uncertainty.

What Happens Before Your First Ketamine Session?

Your treatment journey begins with a thorough safety check. After completing a brief online screener, you'll schedule a video consultation with one of our psychiatric clinicians. This screening protects you by ensuring ketamine is safe and appropriate for your specific situation.

During the 15-20 minute call, we'll review your treatment history, current medications, and vital signs. Some conditions make the therapy unsafe right now:

• Uncontrolled high blood pressure
• Active substance use
• Pregnancy
• Serious heart disease
• Any history of psychosis

This careful screening ensures the medication will actually help you, not just be another disappointment.

Once you're approved, your first two doses arrive in the Innerwell Box, including:

• Clearly labeled medication
• Printed instructions
• Digital access to your treatment guide

On session day:

• Skip heavy meals for a few hours to avoid nausea
• Create a quiet, dimly lit space where interruptions won't happen
• Have a trusted person nearby; they're not there to guide you, just to ensure you feel safe while the medicine works

Take a moment to set an intention. Write down what you hope to understand, release, or discover. This simple step focuses your mind and often shapes the insights that emerge later. When preparation meets intention, you enter treatment ready for the change you've been seeking.

For a complete preparation checklist, see our guide on how to prepare for your ketamine experience.

What Happens During a Ketamine Therapy Session?

1. Right Before Your Session (15 minutes prior)

You'll log into the Innerwell portal and launch an interactive guide that walks you through every step. A brief video check-in with your psychiatric clinician confirms your intention for the session and your baseline blood pressure. You'll dim the lights, choose supportive music, and keep a journal within reach, small details that deepen the therapeutic effect.

2.During Your Session (40-60 minutes)

• Taking the medication:

When it's time to begin, place the rapid-dissolve tablet under your tongue and let it melt completely. Resist the urge to swallow, because holding the medicine in place maximizes absorption. Most people notice a shift within 15-20 minutes. Your companion provides general support during your session and can help contact emergency services if anything feels off.

• The experience unfolds:

The core journey lasts roughly 40 to 60 minutes. In the first ten minutes, you may feel light tingling in your hands or pleasant warmth spreading through your body.

As the medication peaks, many describe a gentle sense of floating, time dilation, or watching thoughts from a peaceful distance, sensations clinicians label "dissociation" that are typically more curious than frightening. Insightful images or memories can surface, so jotting down fragments in real time helps capture material you might explore later in integration therapy.

• Coming back:

Around the one-hour mark, the effects taper, letting you reconnect with your surroundings while lingering calm settles in. You remain conscious throughout; at the low therapeutic doses Innerwell prescribes, the treatment stays well within safe, clinical parameters and doesn't trigger the overwhelming experiences people sometimes fear. Our Ketamine 101 guide explains the science behind how these controlled doses work differently from higher recreational amounts.

3. Right After Your Session

Once you feel steady on your feet, you'll debrief with your therapist over video. Together, you review blood-pressure readings, discuss any emotional themes, and map out integration exercises such as guided breathing or reflective writing.

Because your treatment happens at home, you avoid IV needles and recovery bays common in clinic-based infusions. Yet you still benefit from licensed oversight, personalized dosing, and rapid medication delivery straight to your door.

What Happens After a Ketamine Therapy Session?

You'll feel a gentle come-down first; most people describe it as mild grogginess or soft, floaty relaxation. These sensations typically fade within one to two hours and resolve within four hours at most. Some patients even feel grounded within 10 to 15 minutes and notice an immediate mood lift that can appear the same day. 

Skip driving, operating machinery, or making big decisions right now. Give yourself space to rest, hydrate, and let everything settle.

The next 24 hours bring mild after-effects for most people: nausea, headache, or fatigue. Dizziness or blurred vision happens less often. These reactions fade quickly and rarely need treatment, but Innerwell keeps a clinical support line open daily for patient concerns and provides guidance on accessing support if anything feels concerning outside of these hours. 

Light meals, extra water, and quiet downtime usually resolve any discomfort.

Capture insights while they're fresh to turn a single dose into lasting change. Jot thoughts in a journal, revisit the integration exercises, or work through the step-by-step integration guide. Your therapist will schedule a debrief, and the Innerwell portal's mood-tracking prompts help you log feelings, patterns, and questions. 

These small actions weave the session's clarity into everyday life, sustaining progress between doses.

How Long Does Ketamine Therapy Take?

Most patients complete their initial treatment in four to eight weeks. Your journey begins with Innerwell's Foundation Plan, eight sublingual doses paired with three psychiatric check-ins and a dedicated therapy session, spread across this timeframe.

This structured approach gives your brain repeated opportunities to build new neural pathways. If you're dealing with deeper or more persistent symptoms, the Extended Plan scales up to 24 doses with five clinician appointments. Our guide on how starting ketamine treatment at Innerwell works walks through each plan in detail.

Sessions typically happen once or twice weekly during this initial phase. Each dose builds on the last, creating cumulative neuroplastic changes that traditional antidepressants can't match.

Once your symptoms show sustained improvement, tracked through both clinical scores and your day-to-day experience, you'll transition to maintenance care. Your clinician adjusts this rhythm based on how you're responding, ensuring you get exactly what you need without overdoing it.

What Are the Potential Side Effects of Ketamine Therapy and How Are They Managed?

Even with careful dosing, you may feel a few bumps along the way. During a session, mild anxiety, a flutter of nausea, or brief disorientation are the most common reactions. 

Your therapist stays online to coach breathing or pause the dose until you regain calm. Once the medicine wears off, light dizziness, a low-grade headache, or fatigue are normal and fade after rest.

Serious complications are rare. Blood pressure can rise, so you check it before and after each dose, and clinicians stand by to advise if numbers spike. "Emergence" agitation, an abrupt, unsettling rush as the drug clears, is unusual at sub-anesthetic doses and resolves quickly with reassurance. Bladder damage appears only in people who use high doses recreationally, not in supervised therapy.

Innerwell emphasizes extra protection through oversight by licensed psychiatric providers, therapists trained in psychedelic therapy (including, but not exclusively through, Fluence), pre-session safety protocols, and robust support systems for patients. The medication itself has been a hospital staple since the 1960s, giving us decades of safety data to draw on.

Is Ketamine Therapy Right for You?

You now understand how ketamine therapy works, from your first screening call through post-session recovery. Each 40-60 minute session is guided by licensed psychiatric providers with real-time support, and most patients complete initial treatment in 4-8 weeks.

While other providers charge $200+ per session with unlicensed guides, Innerwell's insurance partnerships bring costs down to $54 per treatment. You get licensed therapists and comprehensive clinical oversight at a fraction of the cost.

Ready to take the next step? Start your free mental health assessment, and our clinical team will guide you forward.

Frequently Asked Questions on Ketamine Therapy

How long does a session last?

You'll feel the medicine working for about 40 to 60 minutes, the period when most of the dissociative effects occur. By 90 minutes, you're usually back to baseline, and any lingering sensations fade within the next hour or so, giving the entire appointment a two-hour footprint from dosing to full recovery. This timeline remains consistent across most patients.

Can I work the next day after a session?

Yes. Acute side effects, grogginess, mild dizziness, or blurred vision typically disappear within four hours, allowing you to sleep normally and return to work the following morning. Just avoid driving or making major decisions until the evening after treatment. Most people find they can resume normal activities without issue.

What if I feel uncomfortable or anxious during the session?

Real-time clinical support is a click away. If anxiety spikes, your clinician can coach you through breathing exercises or other coping skills;, these approaches often help symptoms settle within a few minutes as the session continues. Medication dose changes, when needed, are made gradually over time rather than during a session. Your session companion and 24/7 support line add extra layers of reassurance. The controlled, supervised environment means you're never navigating the experience alone.