Ketamine Therapy: A Week By Week Guide

Medically reviewed by 
Kristin Arden, PMHNP-BC
Published on 
December 16, 2020
Updated on 
June 1, 2021

If you’re considering ketamine therapy for the first time, you may be wondering “How does this all work?

Below is a look at a week-by-week overview of the typical ketamine therapy protocol here at Mindbloom, with a specific focus on Mindbloom’s virtual program structure.

Ketamine Therapy: Week By Week

Week 0: Fit, Guide & Clinician Introductions, and Medical Evaluation

Your first step is to schedule and attend the first meeting with your licensed Mindbloom clinician. 

Be prepared to discuss how you’re feeling, what your goals are, and an in-depth medical and psychiatric history.

If the clinician identifies that you are a good fit for ketamine treatment, the first dosages will be ordered, and your Bloombox will be sent out for delivery.

Week 1: First session and integration guidance

You begin by scheduling your first session and selecting the guide you will work with. Your guide helps you prepare, process, and integrate your experience.

Just before your first session, your guide will discuss safety protocols, take blood pressure readings, confirm dosages, clarify intentions, and address any questions you have. Then you will conduct your first session.

After your session, you will join your guide to create an integration plan for your session. Completing your review forms in the app will help your clinician titrate your dose.

Once your session is complete, you can select your personalized pathway in the Mindbloom app to continue the rest of your program. You can learn how to do so here.

Week 2: Second session and initial results and insights

It is recommended to space your first few sessions between 3-7 days apart. This allows the biological and psychological changes to take place.

With your medical checks in place and Peer Monitor present, you will have your second session. Your guide can help you unpack the experience, suggest integration steps, and hold space for any challenging emotions.

Once complete, there is a mandatory check-in so that our clinical team can make any necessary adjustments required while submitting the remainder of your prescription.

The next few days are spent integrating your experience.

Weeks 3-5: Following your treatment plan.

At this point, you may begin to notice positive shifts in mood. The more you dedicate yourself to integration in between sessions, the more durable the benefits become in the long term.

For your following sessions, the structure remains the same. Your Peer Monitor is present in each session. You can select your own session audio through the app.

You will continue to have contact with your guide, who is there to answer questions, offer advice, or listen if there is anything you need. 

You have the option to add on integration coaching sessions or join a group integration circle.

Week 6: Final session and next steps

Your sixth treatment session marks the end of the first course of treatment.

There is a final medical check-in with your clinical team to monitor your progress and discuss integration and the next steps. 

Your final step is to schedule a check-in with your guide to wrap up your first program.

Week 7: Moving forward

This is your final check-in with your guide. You’ll make a plan for ongoing integration, and take a look at what next steps are available to you.

There are 3 paths clients often take at this point:

  1. Continuing Treatment: For continuing treatment, Mindbloom is available in 6 or 18 Packs. It includes complete access to our pathway library, increased care team access, and added cost savings.
  2. Integration Hiatus: You may opt to take a few weeks to integrate your experience. After that time, you can choose to complete your treatment or to continue with Mindbloom.
  3. Completing Treatment: Some clients feel complete and satisfied with their progress and choose to complete their treatment and return to their lives.

FAQ: Mindbloom Pathways

Here are some questions that are frequently asked about our educational programs, called Pathways.

  • What does each pathway look like?
    Pathways are structured as a pack of 6 treatment sessions. Each treatment session takes about 2-2.5 hours. Each pathway has a particular theme, with all preparation and integration content supporting this.

  • How many sessions are there?
    Pathways have 6 sessions which include preparation, session audio, and integration content, as well as recommended integration steps.

  • What do I need to do?
    Despite being considered a rapid-acting antidepressant (RAAD), ketamine treatment isn’t a “magic pill,” Doing the preparation work, following guidance from your clinician, and continuing your integration work is important.

  • What’s the time commitment?
    Session blocks are 2-2.5 hours long, spaced roughly 1 week apart. A pathway will take about 6 weeks to complete.

  • Can I stretch the pathway out longer?
    To maximize the effectiveness of ketamine treatments, try to keep each dosing session 1-2 weeks apart. There are biological and neurochemical benefits to ketamine as a medicine, which work best when compounded on this timeline.

  • Why are there 6 sessions?
    Each dosing session provides biological and psychological benefits. By stacking a series of sessions closer together in a shorter amount of time, you can maximize the potential effects of the treatment. Mindbloom has developed our protocol to include an initial course of six treatments to build up a solid foundation of the medicine in your system and help you achieve a new baseline.
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This article is for informational purposes only and is not intended to be a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. If you are in a life-threatening situation, call the National Suicide Prevention Line at +1 (800) 273-8255, call 911, or go to the nearest emergency room.

Important FDA Safety Information

Ketamine is not FDA-approved for the treatment of depression or anxiety. Learn more about off-label uses here.

Side effects of ketamine treatment may include: altered sense of time, anxiety, blurred vision, diminished ability to see/hear/feel, dry mouth, elevated blood pressure or heart rate, elevated intraocular or intracranial pressure, excitability, loss of appetite, mental confusion, nausea/vomiting, nystagmus (rapid eye movements), restlessness, slurred speech, synesthesia (a mingling of the senses).

Do not proceed with ketamine treatment if any of the following apply to you:

  • Allergic to ketamine
  • Symptoms of psychosis or mania
  • Uncontrolled high blood pressure
  • CHF or other serious heart problem
  • Severe breathing problem
  • History of elevated intraocular or intracranial pressure
  • History of hyperthyroidism
  • Other serious medical illness
  • Pregnant, nursing, or trying to become pregnant

Ketamine has been reported to produce issues including, but not limited to, those listed below. However, lasting adverse side-effects are rare when medical protocols are carefully followed.

While ketamine has not been shown to be physically addictive, it has been shown to cause moderate psychological dependency in some recreational users.

  • In rare cases, frequent, heavy users have reported increased frequency of urination, urinary incontinence, pain urinating, passing blood in the urine, or reduced bladder size
  • Ketamine may worsen problems in people with schizophrenia, severe personality disorders, or other serious mental disorders.
  • Users with a personal or family history of psychosis should be cautious using any psychoactive substance, including ketamine, and discuss potential risks with your MindBloom® clinician before proceeding with treatment.
  • The dissociative effects of ketamine may increase patient vulnerability and the risk of accidents.

To promote positive outcomes and ensure safety, follow these ketamine treatment guidelines:

  • Do not operate a vehicle (e.g., car, motorcycle, bicycle) or heavy machinery following treatment until you’ve had a full night of sleep
  • Refrain from taking benzodiazepines or stimulants for 24 hours prior to treatment
  • Continue to take antihypertensive medication as prescribed
  • Avoid hangovers or alcohol intake
  • Refrain from consuming solid foods within 3 hours prior to treatment and liquids within 1 hour prior to treatment
  • Ketamine treatment should never be conducted without a monitor present to ensure your safety

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If you're ready to explore ketamine treatment yourself, you can start the process through the link below.

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