Your ketamine infusion is scheduled, and now the practical questions begin. Can I eat beforehand? Should I skip my morning coffee? What about my regular medications? The days and hours before a ketamine session can feel like navigating a maze of dos and don’ts, and conflicting information online only adds to the confusion. Understanding what to avoid before your treatment isn’t just about following rules—it’s about setting yourself up for the safest, most effective experience possible. For a broader look at how to get ready, our guide on tips to prepare for your first ketamine infusion is a great companion to this article. If the preparation process feels daunting, you’re far from alone.
Food and Drink: Why Fasting Matters
The most fundamental preparation guideline for ketamine therapy involves food and drink. Most clinics, including OC Ketamine Therapy, recommend fasting for about 4 hours before your infusion. This means no solid food and typically only clear liquids up to two hours before your appointment. The reasoning is both practical and safety-oriented: ketamine therapy can cause nausea in some patients, and a full stomach significantly increases this risk. More importantly, in the rare event that deeper sedation occurs, an empty stomach reduces the risk of aspiration.
This fasting guideline is familiar to anyone who’s undergone a medical procedure involving sedation, and for good reason—ketamine is an anesthetic at higher doses, and the same precautions that protect patients during surgical procedures apply here. That said, you don’t want to arrive hungry, dehydrated, and shaky from low blood sugar. Eating a balanced meal three to four hours before your appointment strikes the right balance between safety and comfort.
Hydration deserves special attention. Dehydration can make IV placement more difficult and may contribute to post-treatment headaches. Drinking water throughout the day before your session, stopping about two hours before, helps ensure you arrive well-hydrated without a full bladder that creates discomfort during the infusion.
Caffeine: The Stimulant That Works Against Relaxation
Your morning coffee ritual may need a temporary adjustment on infusion days. Caffeine is a stimulant that increases heart rate, elevates blood pressure, and activates the sympathetic nervous system—all effects that work against the calm, relaxed state that supports the best ketamine experience. While a small amount of caffeine early in the day is unlikely to significantly impact your session, consuming large amounts or drinking coffee close to your appointment can contribute to restlessness, anxiety, and elevated vital signs that may complicate treatment.
This doesn’t mean you need to go through caffeine withdrawal on treatment days—abrupt cessation can cause headaches and irritability that aren’t great for your session either. A reasonable approach is limiting yourself to half your usual caffeine intake, consumed well before your appointment time. If you’re a heavy coffee drinker, discuss a tapering strategy with your provider ahead of time.
Medications: What to Discuss With Your Provider
This category requires the most nuanced conversation, because the answer isn’t “stop taking everything.” Some medications may interact with ketamine or reduce its effectiveness, while others are essential to continue for your safety. Benzodiazepines like lorazepam, alprazolam, and diazepam deserve particular attention and should be balanced against the risk of withdrawal or anxiety rebound.
Lamotrigine, a mood stabilizer sometimes prescribed for bipolar disorder, has also been studied for potential interactions with ketamine. Some evidence suggests it may reduce ketamine’s antidepressant effects, though findings are mixed. Blood pressure medications, antihistamines, and other common medications each have their own considerations. The takeaway isn’t to be anxious about your medication list—it’s to be transparent with your provider so they can make informed dosing and scheduling decisions.
The golden rule is: never adjust your medications without explicit guidance from your prescribing physician and your ketamine provider.
Alcohol and Recreational Substances
Alcohol should be avoided for at least 24 hours before your ketamine session, and ideally longer. Alcohol affects many of the same neurological pathways as ketamine, and their combined effects can increase the risk of excessive sedation, respiratory depression, and unpredictable dissociative experiences. Even moderate drinking the night before can leave you dehydrated and with residual neurological effects that may interfere with your treatment.
Cannabis presents its own considerations. While some patients use cannabis for anxiety management, THC can block the antidepressant effects of ketamine. CBD alone may have less interaction, but the research is still limited. Most providers recommend avoiding cannabis for at least 24 hours before treatment.
It should go without saying, but all recreational substances should be avoided before ketamine therapy. Stimulants like cocaine or amphetamines can create dangerous cardiovascular interactions, and psychedelics may compound ketamine’s dissociative effects in unpredictable ways.
Mental and Emotional Preparation: What to Avoid Internally
Physical substances aren’t the only things worth avoiding before your session. The mental and emotional state you bring into the treatment room significantly influences your experience. Stressful conversations, heated arguments, or consuming distressing news or media immediately before your appointment can leave your nervous system activated in ways that work against the therapeutic process.
Amanda, a 41-year-old nurse from Huntington Beach, learned this the hard way: “Before my second session, I had a terrible fight with my sister over the phone on the drive to the clinic. I was still upset when I was getting my IV. That session felt chaotic and anxious, completely different from my first one, which had been so peaceful. After that, I made a rule: no difficult conversations on treatment days. I even stopped checking email an hour before my appointments.”
Creating a buffer of calm before your session is one of the most underrated preparation strategies. This might mean arriving early and sitting quietly in your car for a few minutes, listening to calming music on the drive, or practicing a brief breathing exercise in the waiting area. The goal is to arrive in a state of relative ease rather than heightened stress.
The Night Before: Setting Yourself Up for Success
Preparation for your ketamine session ideally begins the evening before. A good night’s sleep supports better treatment outcomes—fatigue can amplify anxiety and make it harder to settle into the experience. Avoid heavy meals late at night, limit screen time before bed, and keep your environment conducive to rest.
Laying out comfortable clothing for the next day may seem trivial, but it eliminates one source of morning stress. Wear loose, comfortable clothing to your appointment—you’ll be reclining for 40 to 60 minutes, and tight waistbands or restrictive fabric can become distracting. For a full picture of what that time in the treatment room actually looks like, our post on inside a ketamine session walks through the experience from start to finish. Many patients find that having their session-day routine planned in advance helps them arrive feeling grounded and prepared.
What You Should Do Before Treatment
Just as important as what to avoid is what to actively embrace. Do hydrate well throughout the day. Do eat a light, balanced meal at the appropriate time before your session. Do arrange reliable transportation, since you won’t be safe to drive for several hours after treatment. Do communicate openly with your provider about anything that’s changed since your last session—new medications, new stressors, changes in sleep patterns.
And perhaps most importantly, do set a gentle intention for your session. Not a rigid agenda, but a soft guiding thought—something you’d like to explore, release, or understand more deeply. This intention-setting bridges the practical preparation with the therapeutic one, creating a seamless transition from the logistics of getting to your appointment to the deeply personal work of the session itself.
Preparation Is Part of the Healing
Taking time to prepare thoughtfully for your ketamine session isn’t just about following medical guidelines—it’s an act of self-care that signals to your mind and body that you’re committed to your healing. Our team at OC Ketamine Therapy in Newport Beach provides detailed preparation instructions and walks you through every step of the process. Schedule a discovery call to learn how we support you from the moment you reach out through each session and beyond.
References
Frye, M. A., Blier, P., & Tye, S. J. (2015). Concomitant benzodiazepine use attenuates ketamine response. Journal of Clinical Psychopharmacology, 35(3), 334–336. https://doi.org/10.1097/JCP.0000000000000313
Abdallah, C. G., et al. (2018). The effects of ketamine on prefrontal glutamate neurotransmission in healthy and depressed subjects. Neuropsychopharmacology, 43, 2154–2160. https://doi.org/10.1038/s41386-018-0136-3
Sanacora, G., Frye, M. A., McDonald, W., et al. (2017). A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA Psychiatry, 74(4), 399–405. https://doi.org/10.1001/jamapsychiatry.2017.0080
About Dr. Dina Seif
Dina Seif, MD, believes that with the right mindset and support, every one of us has the potential to transform and heal our minds. She specializes in creating a personalized plan for each patient and is committed to providing a supportive healing environment for your journey.
Dr. Seif is a member of the American Society of Ketamine Physicians and was recognized as a Physician of Excellence by the Orange County Medical Association. Dr. Seif has 15+ years of experience with ketamine in the emergency setting and founded one of the first ketamine practices in Orange County in 2019. She has administered thousands of infusions and cared for hundreds of patients from around the world, bringing deep clinical experience to those struggling with severe depression and guiding them toward renewed hope and well-being.
Dr. Seif is board-certified in Emergency Medicine. She is a graduate of the University of California, Irvine, where she attended college, medical school, and business school.
After an internship in Internal Medicine at St. Vincent’s Medical Center in New York, she returned to California for Emergency Medicine residency at LAC+USC Medical Center where she also completed a fellowship in Emergency Ultrasound and was a Professor of Clinical Emergency Medicine at Keck School of Medicine of USC for 5 years.
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. If you are experiencing a mental health crisis or having thoughts of self-harm, please call 988 (Suicide and Crisis Lifeline) or go to your nearest emergency room immediately. The information provided here is not intended to diagnose, treat, cure, or prevent any disease or condition. Always consult with a qualified healthcare provider before starting any new treatment or making changes to existing treatment plans. Individual results may vary, and what works for one person may not work for another.