Mike Cooper, MD
Sitters play an integral part of each ketamine experience. Their presence should create a sense of safety and tranquility. In addition, they are there to ensure that their friend or loved one is safe and well cared for each time they embark on a ketamine experience.
While each person’s journey will be different, here’s how sitter’s can assist before, during and after each ketamine experience.
- Be fully available and present on the day and time of your friend or loved ones ketamine experience.
- If your friend or loved one is working with an Innerwell psychotherapist, briefly join the beginning of their Zoom session at the start of the first 2 ketamine sessions (not applicable to self-guided sessions), so the therapist knows you are there and so you can exchange phone numbers.
- Discuss how your friend or loved one would like you to comfort and support them during the session if they appear anxious or in distress. Some people welcome a hand on their shoulder or having someone hold their hand; others prefer to just have someone by their side without physical contact. This should be discussed prior to starting a session.
During the Session:
- Maintain a quiet and calm atmosphere including making sure all children, pets, noises and distractions are kept to a minimum.
- Be present and aware. Their therapist will need to be able to call or text you to check on them if they have any concerns about their safety or wellbeing.
- Stay within earshot of your friend or loved one in case they need anything. Please do not wear headphones.
- Periodically check on your friend or loved one during their experience (yes, poke your head through the door), but do not interrupt their experience to ask if they’re okay unless they look like they’re in significant distress.
- Assist them in moving around the house if needed - such as walking them to the restroom.
- Offer tea, water, snacks, fruit, blankets, or any other comforts to help them enjoy a smooth after-care.
- Make sure their journal and pen are by their side.
- Remain onsite for the entirety of your friend or loved one’s experience.
- Do not leave them alone in their home until they are back to their baseline (i.e., they are able to hold a regular conversation with you; they are able to walk, talk, eat, and drink normally; they display no significant residual effects other than the following: slight intoxication, mild mental fogginess, mild nausea, and/or slightly blurry vision).
Please note, you are not responsible for “guiding” or actively influencing your friend or loved one’s journey in any way. However, you are welcome to offer emotional support when it is solicited.
Q: How will they consume the ketamine?
A: Your friend or loved one will place their prescribed amount of ketamine lozenges in their mouth, hold and periodically swish the medicine in their mouth without swallowing, and then spit out the medicine into a cup after 10 minutes.
Q: How long do the effects last?
A: Ketamine’s effects begin within 5-10 minutes of ingestion, and the psychoactive effects last for about an hour. Feelings of physical imbalance or being “out of it” may persist for a few hours following their dose.
Q: What should I expect from them during the session?
A: Your friend or loved one will most likely be lying down and remain calm and quiet, listening to music while in a mildly dissociated state throughout the experience. However, it is not uncommon to emote in various ways, such as crying, laughing, screaming, squirming or making loud noises. This kind of response is not a need for concern and may be a part of their psychological process.
Q: Are there any side effects?
A: Physical symptoms such as nausea, drowsiness, and fatigue are common side effects, and should subside within 1-3 hours. Vomiting can occasionally occur if nausea is severe, but will generally subside within 1-2 hours. Your friend or loved one will have been instructed to not eat for 4 hours prior to the start of each medication session (water is OK) to reduce the risk of nausea and vomiting. If the vomiting is continuous and not improving, or if you or your friend or loved one notice blood in the vomit, you should call 911.
Q: What should I do if my friend or loved one appears to be uncomfortable or in distress?
While we encourage you to give them space to experience the highs and lows that can come with psychedelic experiences, if you feel intervention is necessary, there are a few things you can try to help:
- Remind them to return to their breath, remain in the moment, and let thoughts pass by
- Reassure them that they are safe and that this is a temporary experience
- Make sure they are warm and physically comfortable
- Offer a drink of water
- Place a hand on their shoulder for comfort, or hold their hand if you have previously agreed this is something they would want you to do for reassurance
Q: What should I do in case of an emergency?
A: Call 911 if you suspect an emergency. Signs of emergency can include complaints of new chest pain, chest pain that travels down their arm, shortness of breath, excessive sweating, severe headache, vision loss, facial drooping, one-sided arm weakness, or slurred speech.
You should also call 911 if your friend or loved one reports any thoughts of suicide or hurting others, or begins behaving in an erratic, paranoid, bizarre, impulsive or physically aggressive manner, or in any other way that is concerningly out-of-character for them.
Q: Is it possible to overdose?
A: The doses of ketamine that we prescribe do not put anyone at risk of overdose.
If you are interested in learning more about ketamine treatment for mental health, please see our blog post here.