There is really no downside to the treatment, no harm to the patient. At the low dose used for depression the worst thing that will happen is nothing.
It is preferable that you have a mental health care professional actually refer you for the treatment.
You MUST have a mental health care professional to provide chronic care for you, with a visit scheduled preferably the next week. This is very important, I do not follow patients chronically for depression, I only provide the ketamine infusions. I am an Anesthesiologist, I am not a mental health care provider.
You must provide the center with a recent History and Physical from your regular doctor. Typically there is no pre-procedure lab work required unless a need is suggested by your history and physical.
You must provide a complete list of all medications and their dosages. You may be required to taper off or stop some of your medications prior to treatment.
You MUST have someone else drive you to and from treatment and take responsibility for getting you home or to your hotel. It is advisable not to be alone during the 24 hours following treatment.
You will need an IV started but may remain in street clothes. A friend or family member is allowed to stay with you throughout the entire procedure. You may listen to music using your earphones.
You will be offered a very small dose of a sedative if you wish to help you with anxiety. During the infusion, most patients will experience a mild dissociative sensation, most will have some sedation and slight euphoria. In the spirit of full disclosure, it it possible for patients to experience mild dysphoric effects, however I have never witnessed or later had reported to me any dysphoria caused by ketamine in ANY of the depression patients treated by me.
The infusion lasts for one hour. Typically patients are ready to go home within 30 minutes of the conclusion.
Antidepressant effects, IF there are to be any, typically occur anywhere from time of discharge to an hour or two later. Sometimes the effect doesn't happen until the next day, but that is the exception, not the rule.
If the treatment is successful, and it is determined by your mental health care professional that future infusions are necessary to keep recovery progressing, these future treatments can be scheduled more easily.
In addition, in certain cases various outpatient self administered ketamine doses or other extenders can be prescribed to continue the positive effects of ketamine.