For most patients, the first ketamine session is the part of treatment they think about most in the days leading up to it. That’s understandable. Ketamine produces an experience that’s genuinely unlike anything in most people’s prior treatment history, and not knowing what to expect can generate as much anxiety as the session itself. At Nomad Therapeutics, we believe that clear, honest preparation is part of the clinical work — so here is exactly what your first at-home ketamine session involves, from the days before your nurse arrives to the morning after.
Before Your Session: The Days Leading Up
Your medication will arrive two to three days before your scheduled session. No signature is required for delivery, but arrange to bring it inside within two to three hours of arrival. Store it in your freezer, keep it away from light, and do not open or tamper with the packaging. Your nurse will handle the medication at the time of administration.
In the two to three days before your first session, complete any outstanding intake forms in the Osmind patient portal if you haven’t already — these include your medical and mental health history, current medications, allergies, and screening questionnaires. Upload a photo of your government-issued ID and recent weight and blood pressure readings. Review and sign all consent acknowledgements. These steps ensure your clinical team has everything needed to deliver your session safely. Our ketamine FAQs page also covers pre-session preparation in detail.
Avoid recreational drugs in the days leading up to treatment, and no alcohol for at least 24 hours before your session. If your clinician has advised a longer abstention period, follow that guidance specifically.
Setting Up Your Space
The day before your session, prepare the environment where you’ll receive treatment. Choose a space that’s quiet, private, and comfortable — a couch or recliner works well. Dim lighting, minimal noise, and a warm temperature tend to support a more settled experience. Have a blanket, pillow, and water bottle nearby. A light snack for afterward is useful. If you use an eye mask and headphones with a calm, instrumental playlist, prepare those in advance.
Clear a table or surface near your treatment area where your nurse can set up medical equipment. Make sure there’s a clear path to the bathroom. If you live in an apartment or gated building, plan how to let your nurse in at the appointed time. Keep pets and children out of the treatment area for the duration of the session.
The environment you create is not incidental. Research supports that the setting in which a ketamine session takes place shapes what the experience produces (National Institutes of Health). Your own home, prepared thoughtfully, offers a level of comfort and familiarity that no clinical waiting room can replicate. This is one of the core reasons our at-home ketamine therapy model exists.
The Day of Your Session
Have a light meal two to three hours before your appointment. Avoid heavy or fatty foods immediately before the session, and stay normally hydrated — don’t overdrink. Take your existing medications as usual unless your Nomad Therapeutics clinician has specifically instructed you to hold something. Remove your ketamine vials from the freezer approximately 15 minutes before the session starts. Take any anti-nausea medication as prescribed.
Wear comfortable, loose clothing with sleeves that roll up easily. The injection is typically administered in the upper arm.
Arrange your day so that you have no driving, cycling, or operating of machinery for at least eight hours after the session. Don’t schedule work calls, childcare responsibilities, or stressful obligations for the remainder of the day. Plan to rest.
When Your Nurse Arrives
Your Nomad Therapeutics registered nurse will arrive at the scheduled time with all necessary equipment. They will confirm your identity and ask a short set of safety questions — have a photo ID available. They’ll check your baseline vital signs, including blood pressure, heart rate, and oxygen saturation, and review the session plan with you before anything else happens.
Once setup is complete and you’re settled, your nurse will administer the ketamine via intramuscular injection, most commonly in the upper arm. The injection itself is brief. Most patients begin feeling the effects within three to five minutes.
Throughout the session, your nurse monitors your vitals periodically and remains present. You may experience dissociation, changes in perception, emotional release, or a dreamlike quality to your thinking. Common temporary side effects include nausea, dizziness, headache, or a brief period of anxiety. These are expected and manageable — your nurse is trained to support you through them. The acute effects typically fade within 20 to 30 minutes.
After the session, you’ll remain under observation until your vitals are stable. Your nurse will provide discharge guidance and instructions, update your clinical record, and complete the visit. The full session typically runs between 60 and 90 minutes.
After Your Session: Same Day and the Next Morning
Rest. Keep stimulation low. Drink water and eat something light when you feel ready. Avoid alcohol and recreational substances. Avoid major decisions, screens, and stressful situations for the remainder of the day.
Some patients feel emotionally tender in the hours following a session — a heightened sensitivity or openness that can feel unfamiliar. This is normal. Plan for gentle, undemanding time. If you’re doing ketamine-assisted psychotherapy, plan your integration therapy session within 24 to 72 hours when possible. That window — when the neuroplasticity effects of the ketamine are still active and the session is still fresh — is when integration therapy produces its most meaningful results (National Institutes of Health). Journaling in the hours immediately after the session can help you capture insights before they fade.
Side effects at therapeutic doses administered in clinical settings are confirmed as mild and brief (National Institutes of Health). Most patients feel well-rested and clear by the following morning.
We serve patients throughout Seattle, Tacoma, Bellevue, Kirkland, Redmond, Edmonds, Burien, Olympia, and the broader Puget Sound region. Results vary by individual. We encourage you to discuss any questions about your specific session with your Nomad Therapeutics clinical team, and to explore your options carefully before treatment begins.
FAQ
What if I feel anxious before the session?
Some anticipatory anxiety before the first session is common. Your preparation sessions with your therapist are designed specifically to address this — grounding you in your intentions and reducing the likelihood that anxiety shapes the experience in an unhelpful direction. If anxiety is significant on the day of, let your nurse know before the session begins.
Can I have someone with me during the session?
A support person can be present in the home, but should not be in the treatment area during the active session unless your clinical team has specifically arranged otherwise. The environment during the session should be low-stimulation, and additional people in the room can disrupt that.
What if I need to use the bathroom during the session?
Your nurse will help you if needed. This is why a clear path to the bathroom is part of your space preparation. The acute effects of the medication affect balance and coordination, so do not attempt to move around independently during the session without support.
What should I do if something feels wrong during the session?
Tell your nurse immediately. They are trained to respond to physical and psychological concerns and will adjust as needed. For life-threatening emergencies — trouble breathing, severe chest pain, fainting, or seizure — call 911 immediately.
How will I feel the next day?
Most patients report feeling clear-headed and rested by the following morning. Some describe a lingering emotional openness or a subtle shift in perspective that continues for days after the session. These effects vary considerably by individual, and your clinical team will check in with you as part of your ongoing care.
Key Takeaways
- Preparation in the days before your session — completing intake forms, setting up your space, and following pre-session guidelines — directly shapes how the experience unfolds.
- Your Nomad Therapeutics registered nurse arrives with all monitoring equipment, administers ketamine via IM injection, and remains present throughout the 60 to 90 minute session.
- Common temporary effects include dissociation, perceptual changes, and mild nausea or dizziness — all expected, manageable, and typically resolved within 20 to 30 minutes of administration.
- Rest, low stimulation, and no driving or major decisions for at least eight hours after the session are required.
- Integration therapy within 24 to 72 hours of each session captures the neuroplasticity window and is where the session’s insights translate into lasting change.
Knowing what to expect is the first step to showing up prepared. If you’re in the Seattle area and want to talk through whether at-home ketamine treatment is right for your situation, reach out to Nomad Therapeutics for a free consultation. Call or text us at 425-598-7088, or complete the form on our website.
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References
- National Institutes of Health. Ketamine-assisted psychotherapy. https://pmc.ncbi.nlm.nih.gov/articles/PMC9207256/
- National Institutes of Health. Ketamine and neuroplasticity. https://pmc.ncbi.nlm.nih.gov/articles/PMC8190578/
- National Institutes of Health. Side effects of ketamine at therapeutic doses. https://www.nih.gov/news-events/news-releases/side-effects-mild-brief-single-antidepressant-dose-intravenous-ketamine
Medical Disclaimer
The information in this blog is for educational purposes only and does not constitute medical advice. Ketamine-assisted psychotherapy should only be pursued under the supervision of a licensed clinical provider familiar with your full medical and psychiatric history. Results vary by individual. Only a qualified provider can determine whether this treatment is appropriate for your specific situation. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline, available 24 hours a day, seven days a week.