Foundation Reference Guide

Preparing for Infusions

How should I prepare physically for each infusion?

Alcohol and Cannabis

Please avoid drinking any alcohol the evening before each infusion, and the night after the infusion. Similarly, we ask that you avoid cannabis for that same timeframe. These substances will not harm you if you consume them in that window, but they might reduce the beneficial antidepressant effect of treatments.

Eating and Drinking

Outside of alcohol, we otherwise do not have restrictions regarding eating or drinking before your visit. You are welcome to follow your usual dietary routine before your time with us.

Other Medications

Please see the email that we sent you in preparation for your first visit for any information specific to your medications. Please call or email us if you have any questions on this topic.

How should I prepare mentally for each session?

Your state of mind going into each infusion influences the experience you can expect to have during the session itself. To the extent possible, you should come to each visit focused on your goals for care. You are welcome to arrive early and spend time in our reflection areas to ensure a calm and peaceful state of mind going into your treatment. Alternatively, you might consider spending time at any of the places we outlined in your foundation folder. While preparation is helpful and important, don’t overthink it! It is normal to feel nervous in advance of a session. Rest assured, there is nothing you can do to ruin your session.

Your Infusion Experience

Is the way I experienced my infusion normal?

Infusion experiences vary widely from person to person, and often vary from session to session. There is no “right” way to experience an infusion. Some people describe a feeling of connectedness. Others reflect on important relationships. Some describe shapes and abstract concepts. Some describe a peaceful, meditative session void of much thinking at all. Some sessions are highly visual and colorful, while others offer no visual stimuli.

The way that people physically experience infusions also varies. Some people sit quietly while others talk out loud. Some people feel detached from their bodies or sense of self, and others feel distinct physical sensations. Time often feels distorted which may make sessions feel much longer or shorter than they actually are. The most common side effect is a slight feeling of nausea. There will always be a doctor or nurse present at all times during your infusion who is there if you ask for anything, and trained to intervene if there are any concerns at all about your safety.

Sessions are not always easy or enjoyable. Patients sometimes describe grappling with difficult or dark thoughts, and revisiting traumatic memories is not uncommon. Patients often cry in their sessions - with both sadness and with joy. Patients often describe difficult sessions as the most profound and helpful for working through critical issues in their lives.

The most common sentiment people share is that however the sessions take shape, they can help them gain much needed perspective on their lives. We often hear, “It’s like being in therapy with myself.”

Why does Ember Health focus on the experiential components of care - such as aroma, music, and tea?

Evidence reinforces that creating a safe, calming environment can help each patient establish a positive mindset that leads to better clinical outcomes. For this reason, we help each patient articulate their intentions for care and establish a set of supporting rituals that will reinforce those objectives. This includes guidance around the specific smells, sounds, flavors, and feelings that align with desired outcomes. We curate the music and hand blend the teas and aromas ourselves, and are always happy to share more about each.

What can I do to cause the experience that I want?

While we encourage you to focus on your intentions for your wellbeing leading into the infusion, once it starts, you will be most comfortable if you simply “let go.” We recommend that you don’t try to control or force the session to go a certain way. While this would not negatively affect the outcome of your session, it will likely make it feel less comfortable.

After the Infusions

Are there any restrictions around what I can do following care?

You are legally required to refrain from driving or operating heavy machinery for a six hour window after the treatment. We will medically clear you to ensure that you are in a safe and stable state of mind before you are allowed to leave the office. Most clients are medically safe to leave within 30 minutes following the end of their infusions, though we welcome you to relax and reflect in our office for as long as you’d like before you re-engage with the world. You may have a companion pick you up if you’d like, but most of our patients use a rideshare app, take the subway, walk, or hail a taxi to get home. You should have no issue navigating the city once you are cleared at the end of your visit.

How soon will I feel “back to normal” physically following treatment?

While the ketamine will be almost entirely out of your system at the end of the session, ketamine metabolites will remain and tend to make people feel a bit tired (or just mellow) for 1 - 3 hours after the session ends. This is often referred to as an “afterglow.” If you’d like to speed along this recovery process, a brisk walk is usually a good way to shorten this window and get you back to your more normal state of mind more quickly.

How soon can I resume my normal activities following treatment (e.g. return to work, run errands, etc.)?

While you will be medically clear to leave our space quite soon after treatment, you will likely want some time for yourself following your session before resuming normal activities. Most clients reinforce that they deeply value a few hours to relax and reflect following their infusions. For some, this means taking a walk in the neighborhood. Others bring a journal and spend time recording components of their experience. You are welcome in our reflection room as long as you would like before and after treatment, and we can suggest several quiet places in the neighborhood if of interest. While some people choose to return to work after their sessions and resume normal daily routines, we recommend that you try to avoid any stressful engagements for the few hours following your session.

When should I plan to meet with my therapist or other providers?

Evidence suggests there is benefit to working with a therapist within a two week window following your infusions. No one has been able to prove that it is more helpful to need to talk to your providers the same day, or even the next day after, your ketamine infusions.

If you regularly see a therapist, or have decided to start seeing a new therapist as a part of your ketamine treatment then we would encourage you to schedule visits with them as is convenient for you both. Some patients like to schedule their therapy sessions the same day as their infusions so that they can talk through or “integrate” what they experienced while it is still fresh. Others prefer to wait a few days or even a week so that they have time to reflect on their sessions before processing them with other people.

Therapy can be easier to engage in after you have started to feel some relief from your depressive symptoms, which can take a few visits with us before it occurs. There is no right answer on timing your visits. What’s important is that you have the support you need to realize the benefit you seek.

Impacts of Care

When will I start to feel better?

Research supports that 75% of people will realize relief from depression through IV ketamine treatments. Of these, a quarter will feel better after the first infusion, a quarter after the second, a quarter after the third, and the remainder after the fourth.

While ketamine acts quickly, it’s not instantaneous. It can take 7 to 10 days after the 4th foundational infusion for people to feel the improvements they might expect.

What if I feel depressed during the foundation or something difficult happens around the sessions?

It’s normal to feel emotional fluctuations during the foundation, including occasionally feeling bad. Difficult moments - a bad day at work, an argument with a loved one - won’t compromise the outcomes of care.

Even with treatment success, it will be normal to have good and bad days. What defines treatment success is when your emotions become appropriate responses to the circumstances around you.

What if I feel better when we started, but now I feel bad or depressed again?

“Non-linear progress” is a feature of ketamine treatments, particularly during the first few visits when the emotional reward system is shifting into its new state. You might feel moments of relief followed by your more normal depression, or that relief can even make you wonder if the depression is worse than it was before because of the sharp contrasts you might feel in mood. These fluctuations should resolve as you continue your care and the treatment fully takes effect.

Remember that even when these treatments work, you can still have “bad” hours or days, and it is ok to feel sad. Ketamine helps return you to a state of mind where you feel your emotions fully, and negative emotions are appropriate to certain situations in life.

What can I do to maximize treatment success?

You can expect the initial improvements from these treatments to be passive. You should simply start to feel better.

The next set of benefits comes from engaging in positive behaviors such as healthy eating, exercise, therapy, or mindfulness. You will find it easier to adopt these habits and practices as you feel better, and those will heighten and extend the positive outcomes of this care.

Each individual is going to have different behaviors that will be most helpful to them in the weeks around these treatments. We will work with you and your care team to talk through how to best maximize the benefits of your care with us over time.

Health Concerns

Is it normal for me to feel tired following treatments?

Yes, the sessions themselves are both energy intensive and can be psychologically powerful. It is normal to feel tired afterwards. Additionally, part of ketamine’s effect is to help you grow new neurons, and that is also an energy intensive process. People's energy levels should return to normal or even improve as their foundation finishes and their depression lifts.

Should I be worried if I feel nauseous/ lightheaded/ dizzy/ strange after my sessions?

A host of physical side effects have been described after ketamine sessions. These should be mild and limited to the first few hours after the sessions. If these feelings persist for longer than a few hours, or if they are concerning to you, please call the office immediately to discuss with our care team.

Is it normal for me to feel unchanged the day after my infusion?

Yes, it can take some time to improve as you go through the initial four visits. See more above under “Impacts of Care.”

How should I be taking my prescribed medications during treatment?

Please see the email that we sent you in preparation for your first visit for any information specific to any medications you might be taking. Please call or email us if you have any questions on this topic.

What if I have other health concerns?

Please contact us if you have any outstanding questions regarding your health, or are experiencing any concerning symptoms before or after your visit so that we can discuss your care accordingly.