What are potential adverse effects of ketamine therapy?

Agitation, nausea, and/or an increase in blood pressure may occur during the course of a ketamine session and/or immediately afterward. If your agitation is severe, you may be offered medication orally or by injection to help you relax. If you are unduly nauseated, you may be offered the anti-nausea medication ondansetron in pill or oral dissolving tablet forms. If blood pressure monitoring reveals that your blood pressure is too high, you may be offered medication to remedy this.

Visual, tactile and auditory processing are affected by ketamine. Synesthesia, a mingling of the senses, may occur. Ordinary sense of time may be altered.

The administration of ketamine may also cause the following adverse reactions: tachycardia (elevation of pulse), diplopia (double vision), nystagmus (rapid eye movements), elevation of intraocular pressure (feeling of pressure in the eyes) and anorexia (loss of appetite). These reactions generally occur after rapid intravenous administration of ketamine or intramuscular administration of high doses of ketamine (in a range of greater than 5 mg/kg used for a surgical anesthesia; the dose to be used in this sub-anesthetic ketamine therapy is much lower, 2 mg/kg or less).

Is there a psychological risk?

The journey can produce intense, non-ordinary states. These experiences, however uncomfortable, may be of paramount value to your transformation.

Ketamine has been shown to worsen certain psychotic symptoms in people who suffer from schizophrenia or other serious mental disorders. It may also worsen underlying psychological problems in people with severe personality disorders. In order to participate in Transformation, you will complete a medical screening, then meet with a member of our medical staff via Telehealth. You will be asked to provide a medical history, discuss pre-existing conditions and current and past treatments, and share a list of prescription medications and supplements. After this call, if you and our medical staff agree that Transformation is right for you, you will have the opportunity to schedule a retreat. In some cases, we may refer you to a different venue for your first ketamine experience.

Is ketamine addictive?

Ketamine is not considered physically addictive. Some people do find the physical and psychological effects on mood, cognition and perception very pleasant and it has been known to be abused recreationally. However, at the low doses used in ketamine therapy, only given intermittently and under direct medical supervision, addiction is not a significant risk, and has not been observed in clinical studies.

Is the Transformation retreat covered under insurance?

While ketamine’s use is considered “off-label” outside of its use as an anesthetic, your insurance provider may cover some of the other parts of the retreat provided by our licensed health practitioners, such as massage therapy and hot/cold contrast baths.


What is ketamine?

Ketamine was FDA-approved in 1970 and is considered an essential medicine by the World Health Organization. Ketamine has shown to be beneficial in alleviating symptoms associated with anxiety, depression, addictive behavior, PTSD, and chronic pain. Currently ketamine is the only psychedelic substance available outside of research for use in clinical practice. Over the past decade, medical providers have successfully used ketamine in out-patient settings for the treatment of a variety of mental health conditions.

Is ketamine safe?

Ketamine is one of the most commonly used anesthetics in the world and has been used safely for procedural sedation in acute care settings for decades.

Is ketamine approved for treating mental health conditions?

Ketamine is an “off-label” treatment for various chronic conditions including anxiety, depression, PTSD and chronic pain – especially when those conditions have not previously responded to first-line treatments. Ketamine has an extensive record of safety and is used at much higher doses for surgical anesthesia.

While recent work has demonstrated the possibility of an antidepressant response to low doses of ketamine that produce minimal psychedelic effects, psychedelic or ‘dissociative’ experiences may provide an even more robust effect. This effect tends to be cumulative and may be more sustained when repeated. This may result in positive changes to one’s mental health.

How does ketamine work?

Ketamine works partly by balancing activity through the limbic system in the brain, the location that processes fear and pain, so we can experience certain thoughts and emotions without stress or anxiety. It also stimulates the natural process of brain plasticity, with growth of new branches and connections between brain cells. This is a very different pathway than that of other psychiatric drugs such as the SSRIs, SNRIS, lamotrigine, antipsychotics, benzodiazepines, etc.

Preclinical studies suggest that molecular changes induced by ketamine bring forward large-scale network reconfigurations that might relate to ketamine's antidepressant properties. 

A single ketamine journey can help reveal possibilities that seemed out of reach in the past, boost creativity, and create opportunities for positive emotional and behavioral change.

How is ketamine administered?

Ketamine has been administered by intravenous, intramuscular, sublingual, and intranasal routes. For Ten Thousand Waves Transformation, ketamine is administered by intramuscular injection (IM) or intravenously (IV).

What is the dosage?

Dosage depends on prior exposure to ketamine and other psychedelics, body weight, and sensitivity. During your medical intake, you and your medical provider will discuss appropriate dosing for you.

Do I have to stop my other medications?

There are very few medications that interfere with ketamine treatment. You do not need to stop any of your antidepressants. However, please tell your Transformation medical provider about all of your current medications so they can review for any possible interactions. Benzodiazepines such as Xanax and Ativan can decrease the effectiveness of the ketamine treatment. For optimal effect, you should be weaned off these prior to treatment, but any medication changes will be discussed in detail and be done in collaboration with your prescribing physician. Stimulants, such as Adderall or Ritalin should not be taken on the day of your medicine journey.

What are some indications that ketamine is not for me?

Pregnancy and Nursing: Pregnant women and nursing mothers are not eligible because of potential effects on the fetus or nursing child. The effects of ketamine on pregnancy and the fetus are undetermined, and therefore, it is advisable to avoid becoming pregnant before exposing yourself to ketamine, or in the immediate aftermath of its use.

Hypertension: Untreated hypertension is a contraindication to ketamine use as it can cause a rise in blood pressure.

Heart Disease: A history of heart disease may make you ineligible to participate.

Other Medications: We will review your current medications for potential contraindications.

Hyperthyroidism: Ketamine should not be taken if you have untreated hyperthyroidism.

Alcohol Use: We strongly recommend abstaining from alcohol at least 48 hours before and after ketamine sessions, as alcohol use combined with ketamine may cause  negative emotional and physiological consequences. You may talk with your Tour Guide and/or Medical Provider about the use of alcohol before and after the retreat.