2025 05 18 Ketamine Experience

Let me share a few things from my experience, which I am sure, just to be clear format-wise, diverged quite a bit from what you are describing in terms of best practices, duration of IV, etc.

Clinical Setting Choice¶

I chose a clinical setting for a number of reasons:

I wanted to make it as inconvenient as possible for me to use ketamine — we’ll come back to that.
I wanted to standardize the experience and have the versatility that IV provides (which is not the case with intramuscular injections).

This allowed me, during a therapy conversation with a therapist, to dial up the rate of administration mid-session. I remember very clearly increasing the rate by about 20–25% — suddenly things got very strange:

There was a distinct lag between my thoughts, my mouth moving, and me hearing any sound.
It became difficult to talk — like having a delayed reverb on a microphone.

I remember saying:

“John (the technician, a former medic), things are getting a little bendy. Could you please dial back?”

He was able to reduce the rate, and I could resume the session.

The Session Setup¶

Intake process was done beforehand.
I was placed in a recliner, in a private room.
There was a big screen TV where you could choose a nature video with music.
I standardized on a Redwood forest video.

This was the first time I had ever watched a video in a serious or clinical setting during drug administration, which was novel to me.

Dose Escalation and Post-Session Effects¶

We gradually escalated the dose, starting well below the minimum effective dose, then increasing over time.

Post-session effects included:

Recurring short-term memory loss.
I would forget something every time:
My wallet, phone, or backpack.
At home, I’d misplace items or forget where I left them.

This became a running joke with my girlfriend.

Questions Raised¶

How common is cognitive deficit or short-term memory impairment after ketamine use?
What does a clinical setting typically look like in supervised ketamine sessions?

Clinical Responses (From Interview Guest)¶

On Clinical Settings¶

Clinical setups vary:
Some use blank rooms, others use music, eye shades, or ambient visuals.
The goal: maximize accessibility and efficiency.

In the clinic co-led by Dr. Robert Ostroff and Gerard Sanacora:

Setup resembles a surgical recovery room with:
Multiple bays.
Patients shielded by curtains.
Medical staff circulating between patients.

It creates a quasi-communal experience, though not necessarily by design.

On Sensory Input¶

Ketamine distorts perception — the more sensory input, the more distorted the experience becomes.
In contrast:
LSD intensifies under sensory deprivation.
PCP and ketamine lead to greater distortion with increased sensory input.

So, managing the level of stimulation is crucial.

Designing an Optimal Setting (If Cost & Scale Were Not an Issue)¶

If cost and scalability were irrelevant:

The focus would still be on minimizing input.
However, having a comfortable, private, and quiet setting would likely improve outcomes.
A recliner, gentle nature video, low stimulation, and supportive environment would closely resemble an optimized setting.

Reflections on Media Use During Sessions¶

Watching video during ketamine treatment was novel.
One issue: unexpected or mismatched emotional tones in the video content.

"There was one scene in the Redwood video with a fox sitting on a freezing cold beach. It looked absolutely miserable — not conducive to an optimal experience."

At higher doses, this became emotionally impactful in an unintended way. The inability to stop the video mid-session made the experience feel like a ride you couldn’t exit, similar to being strapped into a Disney ride.

Closing Thoughts¶

Content shown during sessions must be carefully curated.
The emotional tone of background media can significantly influence the clinical experience.
There’s a delicate balance between stimulating and overwhelming sensory input during psychedelic-assisted therapy.