What to Expect During Ketamine Therapy: A Complete Session Walkthrough

The most consistent thing patients tell us before their first infusion at Soft Reboot Wellness is that they do not know what they are about to walk into. The clinical literature covers mechanism and efficacy; the internet offers testimonials that range from transcendent to alarming. Neither is quite the same as a practical, honest account of what actually happens, from the first phone call through the days following your final session in the induction series. That is what this post is.

Before You Ever Arrive: The Intake and Consultation Process

Ketamine therapy at Soft Reboot Wellness begins by calling us at 650-419-3330 or emailing hello@softrebootwellness.com. We send you an intake packet to complete, Dr. Herman reviews it, and then determines whether to schedule a consultation. That consultation covers your mental health history, prior treatments, current medications, and what you are hoping to address.

If you have an existing psychiatrist, therapist, or prescriber, we contact them, with your explicit consent, to coordinate on your treatment plan. We are not a replacement for your existing care team; we work alongside them. For patients who do not have outside providers, we work independently and document everything through the Osmind EHR platform, which also includes a mood-tracking app you will use throughout treatment. You can get a detailed overview of what to expect from our clinical process on our dedicated page.

The medical and psychiatric consultation comes before any infusion is scheduled. Dr. Sara Herman or Dr. Natasha reviews your full history to determine whether IV ketamine therapy is appropriate for your specific situation. Not every patient who comes to us is a good candidate, and we will tell you honestly if we do not think we are the right fit. Ketamine is an off-label treatment for mental health conditions, meaning the FDA has not formally approved it for specific psychiatric diagnoses, and candidacy depends on a careful individual assessment.

The Day of Your Infusion

Plan to have someone drive you to and from your appointment. You will not be able to drive yourself home, this is a non-negotiable clinical requirement, not an abundance of caution. Most patients find it helpful to think of the infusion day as a rest day: clear your schedule afterward, have light plans for the evening, and arrive without rushing.

Eat a light meal two to four hours before your infusion and avoid alcohol for at least 24 hours prior. Wear comfortable clothing. You are welcome to bring music, many patients find it significantly shapes the quality of their experience, and we have recommendations if you want them. Our post on music as medicine explores how sound can support the ketamine experience.

When you arrive at our Menlo Park clinic, you will be settled into a comfortable infusion space. Dr. Herman personally administers all IV lines and monitors all sessions from start to finish. A small IV catheter is placed, typically in the arm, and the infusion begins at a slow, controlled rate. Vital signs are monitored continuously throughout the session.

During the Infusion

Effects begin within minutes of infusion onset. What you experience will be personal, no two sessions are identical, and no two patients describe them in quite the same way. That said, certain qualities are consistent enough to be worth describing.

Most patients notice a shift in how their thoughts feel. The relentless quality of anxious or depressive rumination, the loops, the self-criticism, the weight of it, typically softens. Some patients describe it as the mental noise turning down. There may be perceptual changes: a dreamlike quality, altered sense of time, mild visual patterns with eyes closed, or a sense of the mind becoming loosened from ordinary reference points. Some patients experience emotional content, memories, feelings, or imagery that feels significant. Others find the experience largely calm and interior.

The dissociation that many patients fear beforehand tends, in practice, to feel less frightening than anticipated. You remain aware that you are in a clinical setting, that the experience is temporary, and that the care team is present throughout. Research confirms that side effects from a single antidepressant dose of IV ketamine are mild and brief, supporting its safety profile in clinical settings (National Institutes of Health). The session typically runs between 45 minutes and two hours depending on your protocol, and the acute effects resolve fully before you are discharged.

For patients in our ketamine-assisted psychotherapy (KAP) program, the in-office infusion sessions are two hours each. The extended time is designed to allow for a fuller experience and a gentler return, with space for initial reflection before you leave.

Immediately After the Session

The hour following infusion is a transition period. Most patients feel relaxed, occasionally tired, and emotionally open. Some feel moved by what arose during the session; others feel simply quiet. You will rest in the clinic space until you are fully alert and your vital signs have returned to baseline, this typically takes 30 to 60 minutes following the end of the infusion.

After your session, your integration coach checks in before discharge. You go home with your designated driver, and we recommend a gentle evening: no major decisions, no demanding social commitments, no alcohol.

The Integration Window: 48 to 72 Hours After

Research shows that 48 to 72 hours after a ketamine session is the optimal window for integration, the period during which the neuroplastic changes initiated by the infusion are most active and the brain is most receptive to new patterns (American Journal of Psychiatry). This is not the time to push through a demanding workload or ignore what arose during the session. It is the time to pay attention.

Integration coaching sessions are timed around this window. We use the Internal Family Systems (IFS) framework, a model in which different internal states, memories, and protective patterns are understood as distinct “parts” of the self, to help patients engage with whatever surfaced during the infusion in a structured, compassionate way. Dr. Herman has completed training in IFS combined with ketamine-assisted psychotherapy specifically because we believe this window, when used well, is where much of the lasting therapeutic work happens.

For all patients, we encourage journaling, light physical movement, and continuing to log mood data in the Osmind app so we can track your response across the full induction series. Our integration inspirations page offers additional resources for making the most of this period.

What the Full Induction Series Looks Like

A standard induction series at Soft Reboot Wellness involves four to six IV infusions over four to six weeks. Research shows that starting with a series of six infusions produces longer-lasting symptom reduction than fewer sessions, though we calibrate the specific protocol to your clinical response, some patients need fewer, some may benefit from more (American Journal of Psychiatry). Sessions are scheduled once weekly.

The reduction in depressive or PTSD symptoms following the induction series typically lasts approximately five weeks on average, with a range of three weeks to two months for most patients. Subsequent single maintenance infusions, booster sessions, may be used to sustain symptom improvement, typically scheduled anywhere from three weeks to three months after the initial series depending on your individual response pattern.

Addressing the Scheduling and Cost Questions

A ketamine infusion session does not require days of recovery. Most patients return to their normal schedules the following day. We offer appointment times that accommodate demanding professional schedules, because we work primarily with Silicon Valley professionals whose time constraints are real.

IV ketamine for mental health is an off-label treatment, and insurance coverage is inconsistent. We do not want cost to be a surprise, contact us at 650-419-3330 or hello@softrebootwellness.com before your consultation to discuss what the financial commitment looks like for your specific treatment plan. Results vary by individual, and we encourage you to discuss your options with your current providers before beginning.

Frequently Asked Questions

What if I have a difficult experience during an infusion? Challenging experiences during ketamine infusions do occur for some patients, and our clinical team is prepared for them. Dr. Herman monitors all sessions in person and can adjust the infusion rate or intervene if needed. Patients are never left alone during a session. If difficult emotional content arises, this is sometimes part of the therapeutic process, particularly for patients with trauma histories, and our integration coaching is designed to help you work with it rather than simply wait it out.

How will I feel the day after my first infusion? Most patients feel rested or emotionally lighter the day after. Some feel temporarily more fatigued than usual, particularly after their first session. A small number of patients experience mild headache or nausea in the hours immediately following infusion, though these typically resolve quickly. The day-after experience tends to improve across the induction series as the body adjusts.

Can I go back to work the day after a session? For most patients, yes. The acute effects resolve fully before you leave the clinic, and most patients function normally the following day. We recommend not scheduling high-stakes professional obligations on the infusion day itself or the immediate evening after, but the following morning is generally fine.

How do I know if the treatment is working? We track your response through the Osmind mood-tracking app throughout your induction series, so your progress is documented rather than relying on subjective memory. You and our care team review this data together. Meaningful symptom changes typically emerge across the first two to four infusions, though the timing varies between individuals.

What happens at the end of the induction series? At the end of your induction series, we review your mood data and clinical response with you and discuss next steps. Some patients do well without further treatment for an extended period. Others find that occasional maintenance infusions help sustain the gains they have made. We work with you and your outside providers, if applicable, to develop a follow-up plan that fits your actual response pattern.

Key Takeaways

• Ketamine therapy at Soft Reboot Wellness begins with a thorough intake and consultation before any infusion is scheduled; not everyone who inquires is an appropriate candidate.
• Infusion sessions are personally administered and monitored by Dr. Herman; you will need a driver and should plan the treatment day as a rest day.
• The acute experience, altered perception, mental quieting, is temporary and resolves fully before discharge; for most patients it is calmer than anticipated.
• The 48 to 72 hours following infusion are the optimal integration window; our KAP program is specifically structured around this period.
• A standard induction series involves four to six infusions over four to six weeks, with maintenance sessions available afterward based on individual response.

Knowing what to expect removes one of the largest barriers to starting. If reading this has moved you closer to a decision, we are ready to continue the conversation. Call us at 650-419-3330 or email hello@softrebootwellness.com to schedule your consultation at our Menlo Park clinic.

References

1. National Institutes of Health. NIH research confirms that side effects from a single antidepressant dose of intravenous ketamine are mild and brief, supporting its safety profile in clinical settings. https://www.nih.gov/news-events/news-releases/side-effects-mild-brief-single-antidepressant-dose-intravenous-ketamine
2. National Institutes of Health. The National Institute of Mental Health highlights new research supporting ketamine as a rapid-acting depression treatment, offering hope for patients who haven’t responded to standard care. https://www.nimh.nih.gov/news/science-updates/2024/new-hope-for-rapid-acting-depression-treatment
3. American Journal of Psychiatry. Research shows that both single and repeated ketamine infusions can treat treatment-resistant depression, with maintenance infusions extending the duration of benefit. https://psychiatryonline.org/doi/10.1176/appi.ajp.2018.18070834
4. National Institutes of Health. Research supports the integration of psychotherapy with ketamine treatment, showing that the combination may produce more durable and meaningful outcomes than ketamine alone. https://pmc.ncbi.nlm.nih.gov/articles/PMC9207256/

Medical Disclaimer: The information in this blog is for educational purposes only and does not constitute medical advice. Ketamine therapy should only be pursued under the supervision of a licensed medical provider familiar with your full medical and psychiatric history. Individual results vary. Off-label treatments like IV ketamine for mental health conditions carry risks that should be discussed thoroughly with a qualified provider before beginning. 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 or go to your nearest emergency room.