One of the most common questions new patients ask us is “What will my ketamine infusion(s) feel like?”.
To be clear, the vast majority of our patients find their ketamine infusions to be interesting, even pleasant in nature, subjectively speaking. This is due to way we administer our ketamine infusions. Not infrequently however, new patients are concerned that their first infusion will be scary, and that they will undergo a “bad trip”, sometimes referred to as falling into a “K-hole”.
There are several variables that affect the nature of one’s subjective experience during a ketamine infusion. A patient’s attitude and expectations are very important considerations, as is as the dose of ketamine, along with the time period during which it is delivered. Other important parameters include the route of administration, other medications, history with other mind-altering drugs, sleep, hydration status, and other factors.
When giving ketamine for the first time to a new patient, we administer it very carefully, with a gradually increasing rate of delivery, along with frequent questions to ascertain the nature and depth of a patient’s subjective experience. We find that when given in this manner, the overwhelming majority of our patients describe the experience as interesting, pleasant, even euphoric. Certainly, bad trips are possible, but they are almost always avoidable with the combination of a positive attitude by the patient and careful dosing by the provider.
Like other potential side effects of ketamine, such as nausea or a rise in blood pressure, the nature and degree of “bad trips” is dose-dependent, meaning the higher the dose, the higher the potential for an unpleasant subjective experience. Of course, it is important to receive an adequate dose to achieve an beneficial therapeutic response in terms of lowering symptoms of anxiety and depression. Beyond that, though, increasing the dose further just increases the potential for unpleasant infusions.