What to Expect at Your First Ketamine Infusion

Every patient starts with a free intake, not a screening form — Dr. Zabel reviews your history, current medications, and goals, and gives you a specific recommendation. If IV ketamine is appropriate, the standard starting point is an induction series of six infusions over 2–3 weeks, and your first infusion is typically scheduled from there.

Arrange your ride home before you come in. You will not be able to drive yourself after the infusion — plan for a driver or rideshare both ways, or at minimum for the trip home.

Plan to arrive a little before your scheduled time. You will check in, and before the infusion begins, staff check your full vital signs — blood pressure, heart rate, and oxygen saturation — to confirm it is safe to proceed that day. You will be seated in a private treatment room for the session.

An IV line is placed, and your first infusion is delivered at 0.5 mg/kg over 40 minutes — a sub-anesthetic dose given slowly, not a bolus. Dr. Zabel personally monitors this first session and sets your individualized dosing plan based on how you respond. Your heart rate and oxygen saturation are monitored continuously throughout the infusion, and full vitals are checked again once it ends.

For follow-up infusions in your induction series, dosing is titrated from the starting point based on your individual response — there is no fixed escalation schedule, because response varies from patient to patient. Those follow-up sessions are monitored by nurses trained in critical care and emergency medicine, under the plan Dr. Zabel sets, and he is always available for consultation.

Each treatment room is set up for the session itself: custom lighting, an eye mask if you would like one, noise-cancelling headphones, and a curated music selection. You are welcome to use all, some, or none of it — some patients prefer to keep their eyes open and skip the headphones, and that is entirely fine. The goal is a private, comfortable setting for whatever the experience turns out to be for you.

At sub-anesthetic doses, most patients describe a dissociative, dreamlike state — a sense of detachment from the body or surroundings — rather than the deeper unconsciousness associated with anesthetic dosing. Some patients notice changes in perception, mild visual effects, or emotional release during the infusion. Reactions vary considerably between individuals and even between sessions for the same patient. This is not something anyone can predict for you in advance, which is part of why the first session is conservatively dosed and closely monitored. Side effects are covered in detail in IV ketamine side effects and safety.

After the infusion ends, you will stay in the treatment room for a recovery and monitoring period — typically 15–20 minutes — before you are cleared to leave. Exact timing depends on your clinical status returning to baseline, not a fixed clock, so it can run longer for some patients. Your care team will let you know when you are ready to go. You will need someone else to drive you home.

If you are doing the standard induction series, subsequent infusions are generally scheduled over the following 2–3 weeks. Many patients notice initial changes in mood, energy, or outlook within the first few sessions, though response timing varies — the full induction series and your individual response are what shape the treatment plan going forward, not a single infusion. See IV ketamine dosing and the induction series for how titration works across the full series.

A first infusion is deliberately conservative: a well-studied starting dose, continuous monitoring, and Dr. Zabel personally present. The point of the session is as much to learn how you respond as it is to treat — that response is what shapes the rest of your series.

Practically: follow any pre-visit instructions you are given at intake, plan for check-in plus the infusion plus recovery, and have your ride arranged in advance.