Medically Reviewed by Dr. Brijen L. Joshi, MD | Vita Nova Ketamine & Wellness Clinic
If you are researching first ketamine infusion what to expect, the most important thing to know is this: the experience is far calmer and more manageable than most patients anticipate. At Vita Nova Ketamine & Wellness Clinic in Baltimore, your first infusion is a carefully structured, physician-supervised clinical experience — not something to fear. This guide walks you through every step, from the moment you arrive to the moment you get home, so you can walk through our door prepared, informed, and at ease.
Before You Arrive: What to Do in the 24 Hours Before Your Infusion
Preparation in the 24 hours before your first session is straightforward and makes a meaningful difference in your comfort during the infusion. Dr. Joshi and the Vita Nova team will review specific instructions with you during your consultation, but the following applies to most patients.
Food and Drink
Do not eat solid food for at least 4 to 6 hours before your infusion. A light meal several hours before is fine — a heavy meal is not. Clear liquids such as water, black coffee, or plain tea are generally permitted up to 2 hours before your session. Fasting reduces the risk of nausea, which is the most common minor side effect of ketamine infusions. Arriving with an empty but not starved stomach is the goal.
Medications
Continue taking your regular prescribed medications unless Dr. Joshi has specifically instructed otherwise during your evaluation. Do not stop any psychiatric medication — including antidepressants, mood stabilizers, or anti-anxiety medications — without physician guidance. Certain medications may interact with ketamine and Dr. Joshi will have reviewed these during your consultation. If you have any questions about a specific medication, call the clinic before your appointment rather than making a decision independently.
Arrange Your Transportation
This is non-negotiable: you cannot drive yourself home after a ketamine infusion. Arrange a trusted driver — a family member, friend, or rideshare service — before your appointment day. You will be monitored at the clinic until you are clinically cleared to leave, but residual drowsiness and mild disorientation can persist for 1 to 2 hours after the session ends. Plan your day so that your driver is available and your afternoon is free of obligations.
What to Bring and Wear
Wear comfortable, loose-fitting clothing — you will be reclined for 45 to 60 minutes and comfort matters. Bring headphones if you have them; many patients find that listening to calming music or a guided meditation during the infusion enhances the therapeutic experience. Leave valuables and unnecessary items at home. Bring a bottle of water for after the session.
📋 Pre-Infusion Checklist
- No solid food 4 to 6 hours before — clear liquids OK up to 2 hours before
- Continue regular medications unless told otherwise by Dr. Joshi
- Driver arranged — you cannot drive home
- Comfortable, loose clothing
- Headphones packed (optional but recommended)
- Afternoon kept clear of obligations
Arrival at Vita Nova: What Happens When You Walk In
Vita Nova is located at 513 Bayview Blvd in Baltimore’s Canton neighborhood. When you arrive, you will be welcomed by our clinical team in a calm, private environment. There is no busy waiting room energy here — the clinic is intentionally designed to feel like a sanctuary rather than a standard medical office.
Plan to arrive 10 to 15 minutes before your scheduled infusion time. This gives the team time to review your intake paperwork, check your vital signs — blood pressure, heart rate, and oxygen saturation — and answer any last-minute questions you have before the session begins. If this is your very first visit, Dr. Joshi or a clinical team member will do a brief review of your health status to confirm there are no changes since your consultation.
You will then be guided to your private treatment room. The room is equipped with a comfortable reclining chair, soft lighting, and a calm atmosphere. This is your space for the duration of the session — no interruptions, no distractions, just the therapeutic environment your treatment requires.
IV Placement: Quick, Simple, and Minimally Uncomfortable
Once you are settled in the treatment room, a trained clinical professional will place a small intravenous (IV) catheter in a vein in your arm — typically the forearm or the back of the hand. This is the same type of IV line used in any standard clinical or hospital setting. The placement takes under a minute and involves a brief, mild pinch — similar to having blood drawn.
If you have a history of difficult IV access or needle anxiety, let the team know in advance. The clinical staff at Vita Nova are experienced and will take whatever time is needed to make the placement as comfortable as possible. Once the line is placed securely, the ketamine solution — mixed in a saline bag at a carefully calibrated sub-anesthetic dose — is connected and the infusion begins.
The Infusion Experience: What You Will Actually Feel
This is the section most patients are most curious — and most anxious — about. Understanding what the experience actually feels like removes the fear of the unknown, which is often more difficult than the experience itself.
A ketamine infusion for mental health or chronic pain at Vita Nova is administered at a sub-anesthetic dose — meaning it is far below the dose used for surgical anesthesia. You will not be unconscious. You will be awake, aware, and able to communicate with the clinical team throughout the session. The infusion itself runs for approximately 45 to 60 minutes.
The First 10 to 15 Minutes: Onset
Within the first 10 to 15 minutes, most patients begin to notice the onset of ketamine’s effects. The most common early experiences include a mild floating or weightless sensation, a gentle heaviness in the limbs, and a softening of the boundary between internal thoughts and the external environment. Some patients describe a mild buzzing or humming sensation. Colors may appear slightly more vivid. These sensations are gentle and gradual at sub-anesthetic doses — not sudden or overwhelming.
The Middle of the Infusion: The Dissociative State
As the infusion progresses, most patients enter what is clinically described as a mild dissociative state — a dreamlike quality where the external world feels somewhat distant and the internal experience feels more present and expansive. This is a normal, expected, and therapeutically important part of the ketamine experience at sub-anesthetic doses. It is not frightening when you know to expect it.
Patients commonly describe this state as: feeling like you are watching a film rather than living in the moment, a sense of calm detachment from worries and pain, visual patterns or shifting colors when eyes are closed, a slowed perception of time, and a dreamlike but lucid quality. Most patients find the experience neutral to pleasant. A small number find it mildly disorienting on the first session — this typically resolves by the second or third infusion as familiarity grows.
🧠 What Patients Say About the Experience
“It felt like my anxiety just stepped out of the room.” — a common description from GAD patients after their first infusion.
“The pain was still there but I wasn’t fighting it.” — frequently reported by chronic pain patients during the session.
“I kept waiting to feel scared, but I never did.” — the single most common reflection from first-time patients at Vita Nova.
Music, Meditation, and Setting
Many patients choose to listen to calming music or a guided meditation through headphones during the infusion. Research and clinical experience suggest that the internal environment during a ketamine session — what practitioners call set and setting — can meaningfully influence the quality of the experience. We encourage patients to bring a curated playlist or use one of our suggested meditation resources. Soft instrumental music, nature sounds, or purpose-built ketamine therapy playlists work well for most patients. Avoid music with heavy lyrics or emotionally intense content for your first session.
Continuous Monitoring Throughout
Throughout the entire infusion, a clinical professional monitors your heart rate, blood pressure, and oxygen saturation with hospital-grade equipment. You are never alone during the session. If at any point you feel uncomfortable, you can communicate this to the clinical team and the infusion rate can be adjusted. Safety is the primary consideration at every moment of the session.
End of Infusion: Coming Back to the Room
When the infusion is complete, the IV line is closed and the ketamine delivery stops. The dissociative effects begin to lift within minutes. Most patients describe a gradual, gentle return to full awareness — like waking from a vivid dream into a quiet morning. There is no abrupt ending. The transition is smooth.
You will remain in the treatment room for a post-infusion monitoring period of 20 to 30 minutes. During this time the clinical team checks your vital signs again, assesses your orientation and comfort level, and ensures you are ready to transition to the recovery area. You may feel mildly drowsy, pleasantly calm, or slightly emotional — all of these are normal post-infusion responses.
Many patients report that the first thing they notice after the infusion ends is a quiet — a stillness where there was previously noise. For anxiety patients, this can be a profound and unfamiliar sensation. For chronic pain patients, many describe the absence or reduction of their baseline pain as disorienting in the best possible way. These immediate post-infusion impressions are important data — we encourage you to note them, as they help Dr. Joshi calibrate your ongoing protocol.
Recovery and Going Home: The Rest of Your Day
Before you leave the clinic, a clinical team member will review post-infusion care instructions with you and your driver. You will be cleared to leave only when the team confirms you are clinically stable and appropriately oriented.
The First 2 to 4 Hours After Leaving
Residual drowsiness, mild light sensitivity, and a continued sense of calm are common for 2 to 4 hours after your session. This is why a driver is mandatory — do not attempt to drive regardless of how clear-headed you feel immediately after leaving the clinic. The safest approach is to go directly home, rest in a quiet space, and allow the experience to settle. Avoid bright screens, loud environments, and demanding conversations for the rest of the day.
Eating and Hydration After the Session
Start with light, easily digestible food — soup, toast, or fruit — before eating a full meal. Hydration is important; drink water consistently throughout the afternoon. Avoid alcohol for at least 24 hours after your infusion. Alcohol interacts with the neurobiological processes that the ketamine infusion has initiated and can diminish the therapeutic benefit.
Returning to Normal Activities
Most patients return to their normal daily routine — work, light exercise, social activities — the following day. Some patients feel well enough to resume normal activities the same evening. Others prefer an additional day of quiet rest, particularly after emotionally significant sessions. Both are valid. Listen to your body and do not feel pressure to perform normalcy before you are ready.
Keep a Simple Journal
We strongly encourage all patients to keep a brief daily pain or mood journal starting the day of their first infusion. Rate your primary symptom — pain level, anxiety, mood — on a simple 1 to 10 scale each day. This data is invaluable for Dr. Joshi in assessing your response to treatment and optimizing your protocol across the full infusion series. It does not need to be elaborate — three sentences and a number is enough.
What You Might Notice in the Days After Your First Infusion
The first infusion is the beginning of a cumulative process — not a single-session cure. Understanding what to realistically expect in the days that follow helps patients stay the course through a full protocol and accurately interpret their response.
Early Responders
Some patients — particularly those with depression or anxiety — report a noticeable lift in mood, reduction in anxiety, or decreased pain within 24 to 72 hours of their first infusion. This is the neuroplastic effect of ketamine beginning to take hold — the BDNF surge triggered during the session is already promoting the growth of new synaptic connections. If you are an early responder, this is encouraging but should not be treated as the full result. Completing the initial series is important for durable benefit.
Gradual Responders
Many patients notice little change after the first infusion and begin to feel meaningful improvement after the second, third, or fourth session in their series. This is equally normal and does not indicate the treatment is not working. Ketamine’s neuroplastic effects are cumulative — each infusion builds on the last. Incomplete series are one of the most common reasons patients do not achieve their full potential benefit. Trust the protocol and communicate with Dr. Joshi at each stage.
Emotional Processing
Some patients experience a period of heightened emotional sensitivity or vivid dreams in the 24 to 48 hours after an infusion. This is a sign that the brain is actively processing and reorganizing — a healthy neurological response to the treatment. If you find emotions surfacing that feel significant, consider noting them in your journal or discussing them at your next check-in. For patients working with a therapist concurrently with ketamine treatment, the days immediately following an infusion are often reported as particularly productive therapy sessions.
The Full Infusion Series: What Comes After Your First Session
Your first infusion is the first session in an initial series, not a standalone treatment. For most mental health and chronic pain indications, the standard initial protocol at Vita Nova involves 4 to 6 infusions over 2 to 3 weeks. Each session follows the same format as your first — same room, same team, same monitoring, same duration.
As the series progresses, many patients report that the infusion experience itself becomes more familiar and easier to navigate. The dissociative state feels less novel and more manageable. The therapeutic windows between sessions are often when the most meaningful changes in mood, pain levels, or anxiety are noticed. Following the initial series, Dr. Joshi develops a personalized maintenance plan — typically booster infusions every 4 to 8 weeks — based on your individual response.
For a full overview of how ketamine therapy is used for mental health conditions at Vita Nova, read our Guide to Ketamine Therapy for Mental Health in Baltimore. For chronic pain patients, our Guide to Ketamine Therapy for Chronic Pain in Baltimore covers condition-specific protocols in depth.
What Makes Your First Ketamine Infusion at Vita Nova Different
Not all ketamine infusion experiences are equal. The clinical environment, the level of physician involvement, and the quality of monitoring during the session all influence both safety and therapeutic outcomes. Here is what distinguishes the Vita Nova experience.
Physician-Led From Start to Finish
Every patient at Vita Nova is evaluated and treated under the direct supervision of Dr. Brijen L. Joshi, MD. This is a physician-led medical clinic — not a nurse-run wellness spa or a subscription drip bar. Dr. Joshi’s oversight of every protocol means dosing decisions are individualized and medically grounded. The ketamine therapy service at Vita Nova is designed with clinical rigor at every step.
Private Rooms, Not Shared Bays
Every patient receives their infusion in a dedicated private treatment room. There are no shared infusion bays, no strangers in the room, no ambient noise from other patients. Privacy is not a premium option at Vita Nova — it is the standard. For patients with anxiety or social anxiety in particular, this distinction matters enormously.
Telemedicine Option for Your Initial Consultation
If the prospect of a clinic visit feels overwhelming before you have even started, Vita Nova offers a telemedicine consultation as your first step. Discuss your history, symptoms, and candidacy with Dr. Joshi from home before committing to an in-person visit. This is especially valuable for patients with severe anxiety or limited mobility.
Insurance Concierge Service
Most insurance plans do not currently cover ketamine infusions, but Vita Nova’s dedicated insurance concierge service checks your coverage, handles documentation, and does the administrative work on your behalf. HSA and FSA accounts are accepted. Check your insurance coverage here and our team will take it from there.
First Ketamine Infusion: What to Expect at Each Stage
Here is a clear timeline of what happens during your first ketamine infusion at Vita Nova from arrival to going home.
| Stage | Timing | What Happens |
|---|---|---|
| Arrival & Check-In | 10–15 min before | Vital signs checked, paperwork reviewed, settled into private treatment room |
| IV Placement | 5 min | Small IV catheter placed in forearm or hand — brief pinch, then infusion begins |
| Onset | First 10–15 min | Floating sensation, mild heaviness, softened external awareness begins gradually |
| Peak Experience | 15–50 min | Mild dissociative state — dreamlike, calm, detached from pain or anxiety. Vital signs monitored continuously |
| End of Infusion | 45–60 min mark | IV closed, effects begin lifting gradually, gentle return to full awareness |
| Post-Infusion Monitoring | 20–30 min | Vital signs rechecked, orientation assessed, cleared to leave with driver |
| Going Home | Total 90–120 min | Driver takes you home — rest, light food, no screens or alcohol. Return to normal activities next day |
❓ Frequently Asked Questions
Will I be unconscious during a ketamine infusion?
No. Ketamine infusions for mental health and chronic pain at Vita Nova are administered at sub-anesthetic doses — far below the level used for surgical anesthesia. You will be awake, aware, and able to communicate with the clinical team throughout the entire session. You will not lose consciousness.
Is the ketamine infusion experience frightening?
The vast majority of patients at Vita Nova describe their first infusion as calmer than they expected. The mild dissociative state — a dreamlike, floating feeling — can feel unfamiliar at first but is not frightening when you understand what to expect. The clinical team is present throughout and can adjust the infusion rate if you feel uncomfortable at any point.
How long does the entire first visit take?
Plan for approximately 90 to 120 minutes for your first visit — including arrival, check-in, vital signs, IV placement, the 45 to 60 minute infusion itself, and the 20 to 30 minute post-infusion monitoring period before you are cleared to leave.
Can I eat before my ketamine infusion?
A light meal several hours before is fine, but do not eat solid food within 4 to 6 hours of your infusion. Clear liquids such as water are permitted up to 2 hours before. Fasting reduces the risk of nausea, which is the most common minor side effect during infusions.
Will I feel better immediately after my first infusion?
Some patients — particularly those with anxiety and depression — notice a meaningful lift within 24 to 72 hours of their first infusion. Others feel little change after the first session and begin to notice improvement after the second, third, or fourth infusion in their series. Both responses are normal. Ketamine’s effects are cumulative and completing the full initial series is essential for durable benefit.
Can I take my regular medications before a ketamine infusion?
In most cases yes — continue your regular prescribed medications unless Dr. Joshi has specifically instructed otherwise during your consultation. Never stop psychiatric medications without physician guidance. If you have a question about a specific medication, contact the clinic before your appointment.
How many infusions will I need in total?
Most protocols at Vita Nova involve an initial series of 4 to 6 infusions over 2 to 3 weeks, followed by a personalized maintenance plan of booster infusions every 4 to 8 weeks. The exact number is determined by Dr. Joshi based on your diagnosis, response to treatment, and clinical goals — not a fixed standard schedule.
🔑 Key Takeaways
The first ketamine infusion is calmer and more manageable than most patients anticipate — the clinical team is present throughout and the infusion rate can be adjusted at any time.
The entire first visit takes 90 to 120 minutes — including arrival, IV placement, 45 to 60 minute infusion, and post-infusion monitoring.
You will not be unconscious — ketamine infusions at Vita Nova use sub-anesthetic doses. You remain awake and aware throughout.
A driver is mandatory — you cannot drive yourself home. Plan for a quiet afternoon of rest after the session.
Some patients notice relief within 24 to 72 hours of their first infusion. Others respond after the second, third, or fourth session. Both are normal — ketamine’s effects are cumulative.
Vita Nova offers telemedicine consultations as a first step — you do not need to visit the clinic in person to begin exploring whether ketamine therapy is right for you.
All ketamine infusions at Vita Nova, located at 513 Bayview Blvd, Baltimore, MD 21224, are physician-supervised under Dr. Brijen L. Joshi, MD — serving Baltimore City, Baltimore County, Anne Arundel County, and Howard County.
Ready to Schedule Your First Ketamine Infusion in Baltimore?
Now that you know exactly what to expect, the next step is a conversation with Dr. Joshi. Start with a telemedicine consultation from home, or schedule your in-person visit at our Canton clinic. The team at Vita Nova is here to answer every question and make your first infusion experience as comfortable as possible.
References
- National Institute of Mental Health. (2024). Ketamine for Treatment-Resistant Depression. nimh.nih.gov
- Duman RS & Aghajanian GK. (2012). Synaptic Dysfunction in Depression: Potential Therapeutic Targets. Science, 338(6103), 68–72. science.org
- Krystal JH, et al. (2019). Ketamine: A Paradigm Shift for Depression Research and Treatment. Neuron, 101(5), 774–778. cell.com
- Mayo Clinic. (2023). Ketamine for depression: Is it safe? mayoclinic.org
