Your first ketamine therapy session usually lasts two to three hours in office: a short check-in, a sublingual troche that dissolves slowly, an hour or so of altered, dreamlike awareness with a therapist or guide nearby, then rest and conversation. You’ll need a ride home afterward.
This guide walks through the whole arc at SomaVerse, from the week before to the days after. It’s written for first-timers in ketamine-assisted psychotherapy (KAP) at our Lawrence, Overland Park and Topeka offices. Every first session happens in office; supported sessions at home come later, only for people who have completed our main program and are medically approved.
Every person’s first session is different. Some people feel a lot; some feel surprisingly little. Neither one predicts how much the work will help, and your team will meet you wherever you land.
You might be here because…
- Your first dosing session is on the calendar and your stomach flips when you think about it.
- You want to know what ketamine actually feels like before you agree to try it.
- You’re afraid of losing control, or of being stuck in a bad experience.
- You need to plan logistics: time off, a ride, childcare, food.
- You’re the partner or friend driving someone home and want to know how to help.
Before your first session: what’s already happened
By the time you take your first troche, you won’t be walking in cold. You’ll have completed a medical evaluation, in person or by secure video, where our medical team, led by Psychiatry & Ketamine Medical Director Angel Patterson-Tetuan, PMHNP-BC, reviewed your health, medications and blood pressure and approved a starting dose. You’ll also have met with a therapist and a ketamine wellness guide to talk about what you’re hoping for and what scares you.
Our Ketamine Medical Support, Joseph (Valentine) Dee, EMT, has assisted in more than 1,000 ketamine sessions and helps with preparation, sessions and integration, so the medical side of your session is in experienced hands.
In that preparation time you’ll shape an intention, choose or review music, and plan your support: who drives you, who checks on you that evening, and what you’ll do if you feel low in the days after. Our guide on how to prepare for ketamine therapy goes deeper on that part.
Arriving and settling in
Come in comfortable clothes, with layers, because body temperature can shift. Your therapist or guide will greet you, check your blood pressure and ask how you slept, what you’ve eaten and whether anything has changed with your health or medications since your evaluation.
Then you’ll get settled: a reclining seat or mat, a blanket, an eye shade and headphones or speakers. You’ll revisit your intention out loud, and your guide will remind you of a few simple anchors, like noticing your breath or squeezing their hand, that you can come back to if things feel big.
Taking the troche is quiet and unhurried. You let it dissolve under your tongue or against your cheek for several minutes, without chewing, then swallow or spit out what remains as instructed. Many people find the taste bitter or medicinal, and a little numbness in the mouth is common. Our ketamine troche therapy page explains how troches work.
What does ketamine feel like?
Over the next 20–40 minutes, effects build gradually. Most people describe a softening: the body feels heavy or weightless, sounds and music become immersive, and ordinary thoughts loosen their grip. Time can stretch or vanish. With your eyes closed, you might see colors, shapes or dreamlike scenes.
Emotionally, people report everything from deep calm to tears to unexpected tenderness toward themselves. Memories may surface with less charge than usual. Some feel a sense of spaciousness or connection that’s hard to put into words. Others mostly feel relaxed and a bit floaty, and that’s fine too.
You stay conscious. You can usually open your eyes, move, sip water or say a few words, though speech may feel slow. Research suggests a more intense experience doesn’t reliably mean a better result, so there’s nothing to chase. Many people also find dissociation feels less strange with later sessions.
If it gets hard
Sometimes a session brings anxiety, nausea, a sense of disorientation, or grief you didn’t expect. This is one of the main reasons someone trained stays with you. They can adjust the music or lights, offer water or an anti-nausea plan your provider approved, remind you to breathe, or simply let you know you’re safe and not alone.
It can help to remember three things: the effects are time-limited and will ease; difficult material is often the very thing your intention was pointing toward; and you don’t have to figure anything out in the moment. Many clients say the hardest stretch turned out to be the most meaningful once they talked it through.
Bring a ride, and keep the rest of the day open
You can’t drive for the rest of the day after a dose, and that includes rideshare plans where you’d be alone and disoriented. Arrange for a trusted adult to pick you up from the office and, ideally, check on you that evening.
Plan nothing demanding afterward: no work calls, no big decisions, no caring for small children alone, no alcohol. A quiet evening, a simple meal and an early night are ideal. Most people feel back to baseline within a few hours, but tiredness or tenderness can linger until the next day.
Eating, fasting and the morning of
Your provider will give you specific instructions, which often include a light meal several hours before your session. An empty-but-not-starving stomach makes nausea less likely. Follow what you’re told rather than general advice online.
Take your regular medications unless your medical provider has told you otherwise. Skip caffeine-heavy drinks if they make you jittery, avoid alcohol and cannabis the day before and the day of, and try to sleep well the night before.
Aftercare: the first 48 hours
As the medicine eases, usually within an hour or two, you’ll have time to talk with your therapist or guide while the experience is still fresh. Some people want to speak a lot; others prefer to sit with it. A medical check-in follows every dose.
Over the next day or two, be gentle with yourself. Journal a few notes, walk outside, rest and drink water. Feeling raw, tired or unusually open is common. An integration session or an integration group in the days after helps turn what surfaced into something you can use. If you feel worse rather than better, tell your team.
