What does Ketamine or Spravato feel like?

What You Might Feel During Your Ketamine Treatment

It’s very common to feel some nervousness before a first ketamine treatment. This post is meant to provide insight based on what others have described and explain what to expect during the treatment process.

How the Experience May Feel in a Sensory Way

During treatment, many people notice changes in how their body and senses experience the world. These can be unusual, but they are expected and temporary.

Common sensations include:

·       A feeling of heaviness in your body at first, followed later by lightness or a gentle “floating” feeling.

·       Tingling or mild numbness around the lips, tongue, fingers, or toes.

·       Speech that sounds a little slow or thick to you, like after dental numbing or when very relaxed.

·       A sense that your breathing is very slow or has “paused,” even though it has not. Your oxygen, heart rate, and breathing are monitored throughout.

·       Music and sounds that seem richer, louder, more three-dimensional, or, sometimes, muffled or distant.

These sensations do not mean something is wrong—they are part of how ketamine temporarily changes your perception. They fade as the medicine wears off.

Your Inner Experience: Thoughts, Feelings, and Imagery

Inside, the experience often feels calm, dreamlike, or curious. People commonly describe:

·       A sense of stepping back from their usual thoughts, as if watching them from a distance instead of being caught inside them.

·       Worries and painful thoughts feeling farther away or less “loud.”

·       A feeling of emotional softness or calm; for some, a mild sense of euphoria.

·       Scenes with eyes closed such as landscapes, movement, or story-like images.

·       Brief impressions of people they love, meaningful memories, or spiritual/religious imagery that feels comforting.

You may feel partly “somewhere else” while still knowing, in the background, that you are in our treatment room. Most people find this inner experience peaceful or interesting rather than frightening.

A Note About Dissociation

People often worry about the word “dissociation.” In this setting, it simply means a temporary change in how you experience yourself and the room around you—like being in a vivid daydream or watching your thoughts and body from a slight distance.

For many people, this feels neutral to pleasant: floaty, calm, or “stepped back” from their usual stress. Your body is still safe, you are still you, and the feeling passes as the medicine wears off.

Some people notice this clearly; others barely feel it or don’t feel it at all. All of these responses are okay. Dissociation is not dangerous in this monitored setting, and it is not something you have to aim for or force.

Importantly, how intense or “far away” you feel does not reliably predict how well ketamine will help your symptoms. Some people have strong dissociative sensations and improve. Others feel only mild changes—or almost nothing during the session—and improve to the same extent.

If Anything Feels Uncomfortable

Truly frightening or overwhelming experiences are uncommon in a monitored clinic, but we still plan for them. A small number of people may have brief moments of anxiety, nausea, or emotional intensity.

If anything feels like “too much,” you are not stuck with it. We can also slow the infusion or pause it if needed. That’s rarely necessary, but it’s an option we keep available, and symptoms typically ease quickly when the dose is reduced or stopped. During your session, you can:

·       Tell us how you are feeling.

·       Ask for reassurance or help grounding.

·       Ask us to adjust the lights, music, or your position.

·       Receive medication for nausea or anxiety if needed.

We are with you for the entire session and can step in at any time to help you feel safer and more comfortable.

How the Session Unfolds Over Time

The general arc of the experience is similar for IV and intranasal treatment, with small differences in timing.

IV ketamine infusion:

·       Most people notice effects within about 5–10 minutes of the infusion starting.

·       Effects are usually strongest in the middle of the infusion and then gradually fade over the next 30–60 minutes.

Intranasal ketamine/esketamine:

·       Effects usually begin 10–20 minutes after dosing.

·       They build over 30–40 minutes and then slowly fade over the next 1–2 hours.

With both IV and intranasal treatment, you may feel tired, dreamy, or “off” for the rest of the day. This is normal and is why we ask you not to drive or make important decisions until the next day.

Bottom Line

For most people, ketamine treatment feels safe, manageable, and often quite pleasant. Strange sensations—floating, tingling, time shifts, or vivid imagery—are normal parts of the process. Whether your session feels very intense or fairly subtle, the medicine is still working. We will be with you throughout to keep you safe and supported.

What does "works faster" mean for ketamine, esketamine, and traditional antidepressants?

To begin — we only know some of the story

It’s really important to know that the most accurate answer to any "how and why" questions about psychiatric medicine is basically “we don’t know for sure,” to be followed by “our current understanding is….” The science has advanced, but the "how" and "why" cannot be answered conclusively. We simply don’t possess that level of knowledge.

How we thought antidepressants worked (and what we know now)

For many years, the leading idea (by far) was that antidepressants worked mainly by keeping certain neurotransmitters—especially serotonin and norepinephrine—available a little longer in the space between nerve cells (the synaptic cleft). The assumption was that more neurotransmitter in the cleft meant more activation of receptors on the receiving neuron, correcting a presumed deficiency. In other words, there weren't enough neurotransmitters like serotonin to fully signal the next neuron, and if certain neurons didn't get enough serotonin, depression would start.

More recent, comprehensive reviews of the literature call into question this model. We do see increases in synaptic neurotransmitter availability from these medicines, but whether that change by itself explains clinical improvement is uncertain. The field has shifted toward models emphasizing that certain conditions (including medicines and talk therapy) may trigger adaptations (receptor changes, different neuron to neuron signaling, and neuroplasticity) that unfold over weeks. It is believed that these changes lead collectively to improvements in problematic psychiatric conditions.

The good news: the treatments work

Antidepressants—including ketamine and esketamine—have been shown to help many people in randomized, controlled trials. These studies compare treatment with these medicines and a separate placebo (or active control) group. The patients and raters are blinded to which substance is used. For positive findings to be accepted, they must show any benefit is statistically meaningful rather than due to chance. Repeatedly, the studies show these medicines work—even if we don't know exactly why.

Why skepticism is good

It’s important to approach bold claims with a bit of skepticism. You’ll see many explanations for “how ketamine works”; some go beyond what the data support. Our goal is to be both hopeful and accurate—neither over-promising nor failing to accurately report very promising benefits.

How ketamine and esketamine may work faster (short version)

Traditional antidepressants (including SSRIs, SNRIs, TCAs, and MAOIs) may start altering serotonin/norepinephrine systems and then trigger slower downstream changes—neuroplasticity—that often take 2–8+ weeks to reach their lasting benefit. Patients can notice early improvements, but the larger gains usually take time.

By contrast, ketamine and esketamine seem to start in a different place. Rather than working mainly through serotonin, they briefly shift signaling with glutamate—another brain messenger. This appears to open a short window when the brain can rewire more easily, which lines up with the hours-to-days improvements seen in clinical studies.

How fast is “fast,” realistically?

Some patients notice improvements the same day; many notice changes within 24–72 hours after a treatment. Improvements can include significant relief of depressive symptoms and, in some studies, reductions in suicidal thoughts—particularly with IV ketamine. This is faster than what we typically observe with standard oral antidepressants, where clear benefits more often build over weeks.

More detailed information

Important context to know first

• Most ketamine/esketamine trials below enrolled people with treatment-resistant depression (TRD). Your experience and outcome may differ if you’re not in that specific group.

• In any clinical study, some people improve even without the active medicine (the placebo effect or simply getting better over time). Keep that in mind when you look at percentages, because the placebo response was variable from study to study. That said, in all of these examples, the outcomes listed were statistically significant (<5% likelihood the difference was due to chance).

Comparative timing for ketamine, esketamine, and traditional antidepressants

24–48 hours

• IV ketamine: About 64% responded by 24 hours.

• Intranasal esketamine while also taking an oral antidepressant: By ~48 hours, roughly 17% met response criteria.

• Oral antidepressants: Rare to achieve a full response this early; the first meaningful improvement often begins around week 1.

Week 1

• IV ketamine: After a single infusion, many people who improve in the first day are still better at one week; across studies, roughly 35–40% still meet response criteria at Day 7.

• Esketamine: More patients begin to respond significantly as doses add up.

• Oral antidepressants: The first clear improvement is often noticeable by about week 1, though many people still have modest (not robust) changes at that point.

Weeks 2–4 (end of "induction" phase)

• IV ketamine: ~60–70% by 2–3 weeks (after generally 6 treatments).

• Esketamine + oral antidepressant: ~46–61% respond at Day 28 (after about 8 treatments).

• Oral antidepressants: At 4 weeks, many are still improving; by 6–8 weeks, about 50% respond.

Thank you for reading. More ketamine/esketamine information to follow soon . . .

Please remember that the medical information on this page is educational and not a substitute for personalized medical advice.

Ketamine Matters. The Where and the Who Matter Even More.

Why Ketamine Matters

• Ketamine offers a different path for people facing hard-to-treat mental health conditions—especially depression.

• It is not new to health care, but it has uncovered new pathways to take the fight to stubborn, resistant, refractory depression.

• It can “jump-start” treatment—some people notice relief within hours; others within a few sessions.

• Ketamine helps strengthen brain pathways to allow healthier communication patterns between brain cells (neuroplasticity).

Why "Where" Matters

• Because Zionsville Ketamine Means:

  • Private, calming rooms — a step above.

  • A mental health clinic run by mental health experts.

  • Mental health is the point, not an add-on.

  • Personalized dosing: informed specifically by your genetic, physical, and metabolic profile to reach your predetermined peak-level targets.

  • Physician-directed care. Start to finish.

  • Clear safety protocols: science-based, evidence-driven care for your mind.

  • Real screening, progress monitoring, coordinated aftercare.

Why "Who" Matters

• Because at Zionsville Ketamine:

  • Ketamine is Psychiatric Medicine. That’s what we do—start to finish.

  • You are cared for directly by a psychiatrist who owns the practice.

    Christopher Dull, MD, JD — ABPN board-certified psychiatrist.

    • MD, Vanderbilt University.

    • Psychiatry Residency, Johns Hopkins.

    • Advanced Ketamine Training, Ketamine Research Institute.

    • JD, Indiana University.

  • We provide continuity of care and coordination with your own therapist/prescriber.

  • We practice data-guided dosing: the science of you (genetics when relevant, weight and physiology, targeted peak-level goals).

  • Safety—above all. We follow the most rigorous, safety-based protocols. Dr. Dull is ACLS/BLS certified.

    
    

So…

We’re here to partner with you and your team—and unify the Why, the Where, and the Who. Just for you. Together, we’ll create a well-rounded, thoughtful treatment plan rooted in mental health, medical rigor, safety, and care.