Tips for Reducing Nausea During Ketamine Therapy

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Ketamine therapy has emerged as a groundbreaking treatment for mental health conditions such as depression, anxiety, PTSD, and chronic pain. While it provides significant therapeutic benefits, some individuals experience side effects, with nausea being one of the most common. Nausea can be uncomfortable and, in some cases, may impact the treatment experience. Patients tend to experience nausea after treatment (and not during). Aiming to prevent nausea tends to be a more successful approach. While it’s an uncomfortable symptom, patients can rest easy knowing that they are still receiving the benefits of ketamine for their mental health, even if they do get nauseous.

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There are several strategies that patients can use to minimize the likelihood of nausea. In this article, we will explore the causes of ketamine-induced nausea and provide actionable tips to reduce its occurrence.

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Understanding the Causes of Nausea from Ketamine Therapy

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Some people’s bodies are more prone to nausea than others. We find that about 10-15% of patients may experience some nausea after ketamine. Nausea during ketamine therapy can stem from several factors, including:

• Ketamine’s Effects on the Vestibular System: Ketamine can impact the inner ear, leading to dizziness and nausea.
• Gastrointestinal Sensitivity: Some individuals have sensitive stomachs that react strongly to ketamine’s effects.
• Pre-existing Conditions: Those prone to motion sickness or migraines may be more susceptible.
• Psychological Factors: Anxiety or fear before a session can contribute to nausea.
• Medication Dosage: Higher doses are more likely to produce nausea, though this threshold varies from person to person.

Understanding these factors can help in developing effective strategies to manage and prevent nausea during ketamine therapy.

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Pre-Treatment Tips to Prevent Nausea

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1. Eat Light and Choose the Right Foods
   
   • Avoid heavy, greasy, or spicy meals before treatment.
   • Opt for a light snack such as toast, crackers, or a small portion of fruit before your session.
   • Fasting for at least 3-5 hours before treatment may be recommended by your provider. For this reason, many opt for scheduling morning treatments when possible and just skipping breakfast.
2. Stay Hydrated but Avoid Excessive Fluids
   
   • Drink plenty of water the day before and throughout the day of treatment but limit or stop fluid intake 2-3 hours before your session to prevent nausea.
   • Avoid all caffeinated or carbonated drinks, which may increase stomach discomfort. (Caffeine is a stimulant which can also negatively impact the experience by preventing someone from fully relaxing and sinking deeper into the journey.)
3. Discuss Anti-Nausea Medication with Your Provider
   
   • We always offer anti-nausea medications like Ondansetron (Zofran) before treatment, when it is not contraindicated with the other medications someone is taking.
4. Manage Anxiety Before Your Session
   
   • Deep breathing exercises, meditation, and guided imagery can help calm the nervous system and reduce nausea triggered by anxiety.
   • Consider listening to calming music or engaging in light stretching before your session.
   • We also recommend taking a short walk the morning before your session to work out any anxious energy you may have stored in your body.

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During Treatment: How to Minimize Nausea

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1. Choose a Comfortable Position
   
   • Lying down in a relaxed position with minimal movement can help prevent dizziness and nausea.
   • Avoid excessive head movements, as they may worsen nausea symptoms.
2. Control Your Breathing
   
   • Slow, deep breaths can help regulate your nervous system and reduce nausea.
   • Breathing exercises such as the 4-7-8 technique (inhale for 4 seconds, hold for 7, exhale for 8) can be beneficial.
3. Use Aromatherapy
   
   • Essential oils such as peppermint, ginger, or lavender can help soothe nausea. We generally have one or two of these essential oils in a diffuser during your treatment.
   • You can also apply a small amount to your wrists (just ask us!).
4. Limit Sensory Overload
   
   • Bright lights and excessive noise may intensify nausea.
   • Consider listening to calming music or engaging in light stretching before your session.
   • Our patients always wear an eye mask during treatment, and we keep the treatment room dimly lit to help create a calming environment.

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Post-Treatment Strategies to Prevent Lingering Nausea

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1. Rest and Take It Easy
   
   • Avoid sudden movements and allow yourself time to rest after treatment.
   • Remain in a reclined or semi-reclined position for a short period before getting up. This is another reason to avoid filling your bladder beforehand - so you don’t have to get up to use the bathroom too quickly.
2. Drink Ginger or Peppermint Tea
   
   • Herbal teas containing ginger or peppermint can help soothe the stomach post-treatment. We offer ginger tea to all of our patients after treatment.
   • Sipping slowly can prevent irritation.
3. Consume Bland Foods
   
   • If you experience nausea after treatment, opt for mild foods such as crackers, bananas, or plain rice.
   • Avoid acidic or spicy foods until your stomach settles.
4. Consider Over-the-Counter Remedies
   
   • Medications such as ginger supplements, motion sickness bands, or antacids may help reduce lingering nausea. We offer ginger chews in our practice.
   • Consult with your healthcare provider before taking any additional medications.
5. Engage in Gentle Movement
   
   • Light stretching or a short walk can help regulate digestion and reduce nausea.
   • Avoid intense physical activity until nausea subsides. Laying down with eyes closed tends to be the most comfortable position during nausea.

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When to Seek Medical Advice

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While nausea is a common and usually mild side effect of ketamine therapy, there are times when medical guidance may be necessary. Contact your healthcare provider if:

• Nausea is severe and persistent beyond the typical recovery period.
• You experience vomiting that does not subside.
• Additional symptoms such as dizziness, confusion, or difficulty breathing occur.

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Conclusion

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Nausea during ketamine therapy can be an uncomfortable experience, but with the right preparation and management strategies, it can often be minimized or avoided. By following pre-treatment guidelines, incorporating in-session techniques, and using post-treatment care strategies, patients can enhance their ketamine therapy experience with minimal discomfort. If nausea continues to be an issue, working closely with a healthcare provider can help tailor the treatment approach for improved tolerance and effectiveness. By prioritizing comfort and care, ketamine therapy can remain a powerful and transformative healing tool.