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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:

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:

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.


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 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.

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.

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.

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.


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

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.

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.

Learn what happens during ketamine therapy from screening to recovery. Understand the timeline, session experience, and side effects.

Ketamine Therapy: What to Expect Before, During & After

Introduction

How Long Does Ketamine Therapy Take?

FAQs

Trying to figure out whether you can legally start ketamine therapy can be confusing. One site tells you ketamine is a tightly controlled anesthetic, another promises doorstep delivery, and state maps light up with conflicting rules.

Ketamine has moved beyond the peripheral stigma and out-of-date scepticism. Today, it's a well-researched, proven method for treating depression and other mood disorders. Nevertheless, its status as a Schedule III controlled substance still impacts its accessibility.

Because every state layers its own rules on top of federal law, the path to care changes at each border. This guide breaks down ketamine laws by state to help you understand how it’s regulated. 

Yes, ketamine therapy is legal when prescribed by a licensed medical provider, but as a DEA Schedule III controlled substance, it also carries real abuse potential. Careful regulation is therefore necessary.

Schedule III substances are drugs with accepted medical uses but moderate-to-low potential for physical dependence or high psychological dependence - placing ketamine in the same category as certain steroids and stimulants.

Any clinician prescribing or administering ketamine for therapeutic reasons needs DEA registration, plus meticulous record-keeping. We're talking detailed inventories, security protocols, and documentation down to how vials are stored and counted.

Federal law sets the baseline for ketamine as a Schedule III controlled substance in the United States, and each individual state adds its own layer of regulation. This arrangement impacts treatment accessibility depending on where you live and seek treatment. Three key factors drive the differences you'll encounter:

Corporate Practice of Medicine - states like California, New York, and Texas require physician ownership of medical practices, which limits who can open ketamine clinics.

Medical board oversight intensity - some states issue advisory guidelines, while others mandate detailed consent forms, on-site physician presence, and regular audits.

Comfort with off-label use - certain progressive states may allow nurse practitioners to run infusions under physician protocols or permit at-home sublingual treatments.

The level of caution or freedom a state applies to ketamine therapy impacts both availability and perception of quality: 

Stricter rules can increase costs and limit access.

Flexible rules increase access but can leave patients questioning quality.

The regulatory environment varies dramatically across states, creating distinct environments for accessing ketamine treatment.

*Information presented in this table is intended for general informational purposes only. It does not constitute legal advice. Laws and regulations change and vary, and readers should always seek clarity from their physician or healthcare provider first. 

You can legally access ketamine therapy through telehealth in many states, but the rules are complex and constantly evolving. The COVID-19 pandemic accelerated the adoption of telemedicine, and ketamine therapy expanded alongside it through emergency federal flexibilities for remote prescribing of controlled substances.

While the DEA has never explicitly banned at-home ketamine treatment, state medical boards and corporate practice of medicine doctrines ultimately determine whether remote care can legally operate in each jurisdiction, and how.

The real obstacle is finding providers who actually comply with medical standards and regulations. Some telehealth platforms rush patients through brief online questionnaires, ship sublingual tablets, and call it therapy.

Innerwell takes a different approach by maintaining the convenience of at-home dosing while incorporating clinical rigor throughout the entire treatment process. Treatment begins with a comprehensive psychiatric evaluation conducted by licensed prescribers, not automated questionnaires.

Master's- and doctoral-level therapists guide preparation sessions, provide real-time virtual support during each dose, and offer integration therapy afterward to maximize therapeutic benefits.

What Should You Look for in a Legal Ketamine Provider?

A legal ketamine provider must follow the same controlled-substance regulations that govern hospitals and medical centers. Look for:

Proper licensure verification - the prescribing clinician must maintain active state medical licenses and location-specific DEA registration.

Comprehensive initial evaluation - expect a thorough psychiatric and medical evaluation before your first dose.

Session safety protocols - proper at-home ketamine therapy includes pre-session vital sign checks, real-time virtual oversight from licensed therapists, clear emergency protocols, and guidance on when to seek immediate medical attention.

Detailed documentation - legitimate clinics document every milligram dispensed and maintain consent forms, dosing records, and adverse-event reports.

Ongoing therapeutic support - comprehensive care extends beyond individual sessions through integration therapy and scheduled follow-ups.

Innerwell incorporates these clinical benchmarks into an at-home model without compromising safety standards:

Board-certified psychiatric oversight - our providers conduct thorough video evaluations, write and manage prescriptions under their own DEA registrations, and collaborate with master's- and doctoral-level therapists who guide each treatment session.

Comprehensive care beyond dosing - your personalized care plan includes trauma-informed modalities like EMDR, routine symptom tracking, and direct communication with your treatment team.

Insurance accessibility - partnerships with major insurers help reduce out-of-pocket expenses, making properly regulated care more financially accessible.

We’ve covered how Ketamine therapy is regulated under federal law and explored the state-by-state variations that affect access, from scheduling rules and clinic ownership requirements to telehealth limitations and geographic factors. Displaying those differences side-by-side highlights how state-specific regulation can meaningfully shape your treatment options.

At Innerwell, we believe in bringing clinically sound ketamine-assisted therapy into frameworks that respect both legal regulation and individualized care. Through personalized screening, licensed provider oversight, and accessible at-home protocols, we aim to simplify the pathway to safe, effective treatment, wherever your state falls in its regulatory landscape.

Ready to understand if ketamine therapy might be the right next step for you? Take our free self-assessment.

Complete guide to ketamine therapy laws in all 50 states. Learn federal DEA requirements, state regulations, and telehealth rules.

Ketamine Laws by State: 2025 Guide

Is Ketamine Therapy Legal?

Why Do Ketamine Laws Differ By State?

Ketamine Laws by State (2025)

Can You Get Ketamine Therapy Online?

Start Your Ketamine Journey

About 50% of patients don't respond to their first antidepressant. Ketamine therapy offers a different mechanism of action—one that works through novel brain pathways and can produce results within hours instead of weeks, but that doesn’t mean ketamine therapy is right for everyone. 

Ketamine therapy requires true treatment resistance, tolerance for dissociative side effects, commitment to ongoing therapy work, and access to qualified providers. Whether it's right for you depends on your specific clinical profile, practical circumstances, and readiness to engage.

This guide walks you through seven decision-making questions. By the end, you'll have a better idea of whether ketamine therapy is worth pursuing for your situation.

Important: This information is educational, not medical advice. Only a licensed professional who knows your complete medical history can determine if ketamine suits your situation.

Why You’re Considering Ketamine Therapy

Many people exploring ketamine therapy have already tried standard treatments. Some experience success, while others enjoy brief moments of improvement that fade. Others see no change at all.

The mental weight of wondering whether things will ever improve can be exhausting. You may be researching ketamine therapy because you’re looking for something different, but you’re right to be cautious. It’s essential to cover the basics before diving in. 

Ketamine therapy has produced meaningful results for many people with treatment-resistant depression and anxiety, but it's not a universal solution. It requires proper medical oversight, realistic expectations, and integration into a broader mental health plan.

7 Questions: Is Ketamine Therapy Right for Me?

These seven questions cut through the marketing claims and provide the framework needed to determine if ketamine therapy aligns with your individual situation.


1. Are Your Depression or Anxiety Symptoms Truly Treatment-Resistant?

Treatment-resistant depression or anxiety means standard options no longer work. In practical terms, you cross that threshold after trying at least two different antidepressants, each at therapeutic doses for six to eight weeks, without meaningful relief according to Mayo Clinic guidance. 

You're not alone: around one-third to one-half of people with major depression don't improve after their first antidepressant.

Before labeling symptoms "treatment-resistant," clinicians must confirm that you meet criteria for Major Depressive Disorder. The DSM-5 framework requires five or more specific symptoms—persistent low mood, loss of interest, changes in sleep or appetite, or recurrent thoughts of death—present during the same two-week period, severe enough to disrupt work, relationships, or daily functioning.

Have you completed at least two full courses of antidepressants at prescribed doses?

Taken each medication consistently for six weeks or longer?

Tried evidence-based therapy like CBT for at least eight sessions?

Addressed medical conditions like thyroid problems?

Are you using alcohol, cannabis, or supplements that might interact with medications?

Recognizing true treatment resistance ensures you don't leap to advanced therapies prematurely, and spares you the frustration of repeating approaches that won't help. If you've exhausted these options, ketamine therapy might be a good next step to explore with your healthcare provider.


2. Will Ketamine Therapy Match Your Expectations?

Ketamine works through a completely different pathway than traditional antidepressants by blocking the brain's NMDA receptors and triggering a surge of glutamate that sparks new neural connections. This is why many people notice a shift in mood within hours.

Clinical research shows IV ketamine produces significant antidepressant effects within hours to days for many patients with resistant depression. Esketamine nasal spray acts almost as quickly, while oral or sublingual lozenges build more gradually over the first few sessions.

Rapid relief doesn't mean universal relief. Roughly one in five patients feels a minimal change after an initial series, and even strong responders may need periodic booster doses. Your diagnosis, metabolism, concurrent medications, and delivery method all shape response.

The advantage of ketamine therapy is the faster feedback loop: instead of waiting a month to see if a medication helps, you'll know within a session or two whether ketamine is working. If it isn't, you can pivot without losing another season to trial-and-error.


3. Can You Access Ketamine Therapy and Commit to the Treatment Format?

Ketamine therapy comes in several forms, each with different time commitments, costs, and accessibility requirements. Understanding what's actually feasible for your situation matters as much as clinical fit.

Oral sublingual tablets offer the most flexibility, avoiding needles and clinic appointments entirely. At-home programs like Innerwell ship pre-measured tablets, a digital blood-pressure cuff, and a dosing guide directly to your door. 

Intramuscular (IM) injections step up the clinical involvement slightly, requiring quick clinic visits or mobile services. Effectiveness and costs fall between IV and oral options, but you'll need access to a provider offering this format and reliable transportation to appointments.

Nasal sprays (FDA-approved esketamine) require two-hour supervised clinic visits where you'll spray the medication under nurse observation. You'll need reliable transportation and a clinic within a reasonable distance.

Intravenous (IV) infusions represent the most time-intensive option, requiring in-clinic visits lasting several hours with continuous vital-sign monitoring. If you live far from specialty clinics or can't take multiple half-days off work, this option becomes impractical regardless of its clinical benefits.

The practical reality: The question isn't which format is "best" in the abstract; it's which you can actually access and sustain over the course of treatment.


4. Do the Risks and Requirements Align With Your Health Profile?

Ketamine is a potent medication, even at the low doses used for mental health care. Before committing to treatment, you need to understand both the common side effects most people experience and the medical conditions that make ketamine unsuitable.

Floating sensation, lightheadedness, or shifts in perception

Dissociation, which typically fades within an hour

Dizziness, nausea, or brief blood pressure spikes

Long-term risks deserve careful consideration. Repeated high-dose or unsupervised use can cause bladder inflammation and, rarely, elevated liver enzymes. Because ketamine is a controlled substance, reputable clinics monitor for any signs of dependency or misuse.

Conditions that make ketamine unsuitable:

Uncontrolled high blood pressure or serious heart disease

Medications that raise blood pressure or significantly affect brain chemistry

Quality programs build safety into every step—medical screening with labs when needed, real-time monitoring during treatment, mandatory recovery periods, and follow-up calls checking for lingering effects. 

Ask yourself: Are you willing to experience temporary dissociation and other mild side effects? Do you have any medical conditions that would rule you out as a candidate? Can you commit to safety protocols like monitoring your blood pressure and having a clinician available during sessions? 

If the answer to any of these is uncertain, ketamine therapy may not align with your current health profile or comfort level.

5. Are You Ready to Commit to Integration and Ongoing Therapy?

Ketamine works best when paired with structured psychotherapy. If you're expecting a medication you can take passively without additional therapeutic work, ketamine therapy probably isn't the right fit.

Wondering if ketamine therapy is right for you? Answer 7 helpful questions about resistance, costs, and risks to decide if it's the right fit.

Reflections

Ketamine Therapy: What to Expect Before, During & After

Ketamine Laws by State: 2025 Guide

Is Ketamine Therapy Right for Me? 7 Questions To Ask Yourself

How Does Your Body Metabolize Ketamine? A Complete Guide

Atypical Depression: Recognizing Hidden Symptoms and Rethinking Treatment

Rethinking ADHD: A Multimodal Path to Focus & Balance

Preventing Trauma Before It Starts: The Future of Resilience-Based Mental Health