Your questions, answered.

Ketamine is a legal Schedule III medication that has been FDA-approved since the 1970s and is widely used in hospitals for anesthesia and pain management.

In mental health care, it is commonly prescribed off label, meaning licensed clinicians can use it in ways supported by research, including for depression, anxiety, and trauma.

When used in a therapeutic setting, ketamine is carefully prescribed, dosed, and monitored by licensed medical providers. You will always go through a medical screening process to ensure it is safe and appropriate for you.

Ketamine acts on the brain in a unique way compared to traditional medications. Instead of primarily targeting serotonin, it works on NMDA receptors within the glutamate system, which plays a key role in learning, memory, and emotional processing.

This action increases neuroplasticity, helping the brain form new neural connections and pathways. In simple terms, it creates a temporary “window” where rigid thought patterns can soften and new ways of thinking and feeling become more accessible.

Research also suggests ketamine can help quiet the brain’s default mode network, which is often overactive in depression and linked to rumination and negative self-talk. This is part of why many people experience relief from looping thoughts and a greater sense of mental space.

For many people, this can lead to:

• Rapid reduction in symptoms of depression and anxiety
• Increased emotional flexibility and resilience
• Reduced reactivity to past experiences
• New perspectives and meaningful insights
• A more compassionate relationship with themselves

Unlike traditional medications that may take weeks to build, ketamine can create noticeable shifts within hours to days for some individuals.

The medicine opens the door, but the real transformation happens in how those experiences are integrated into your life. This is not just about temporary relief. It’s about creating new patterns in the brain that support lasting change.

The medicine typically begins to take effect within 10 to 15 minutes, with the main experience lasting around 45 to 75 minutes. The exact length can vary depending on factors like your metabolism, whether you’ve eaten, and how easily you’re able to settle into the experience.

Around 75 to 90 minutes, most people begin to gently emerge from the journey. You’ll know when it’s time; there’s often a natural sense of returning. As you come out, you may feel slightly groggy or inward. With some time, hydration, light nourishment, and reflection, most people feel back to baseline within a few hours.

It’s important to give yourself space afterward to rest, integrate, and allow the experience to settle.

You remain aware throughout the experience.

While your usual thought patterns may shift, many people actually feel more connected to themselves and able to observe what is happening with greater clarity and calm. Instead of being pulled into emotions or old patterns, there is often more space between you and what you’re experiencing.

The goal is not to overwhelm your system, but to help you access deeper parts of yourself in a way that feels safe and supported.

Sarah is a licensed therapist, and this work is grounded in clinical, trauma-informed care. It is also deeply spiritual. Many people experience a connection to their higher self, a sense of energy moving through the body, or a felt sense that we are all connected.

You don’t need any particular beliefs to do this work. Some clients come with a rich spiritual practice; others simply want relief and to feel like themselves again. Your experience is yours, and every part of it is welcome.

A “k hole” refers to a very high dose of ketamine where someone can feel fully dissociated and separate from their body or surroundings, sometimes to the point of feeling disconnected from reality or unable to move or communicate.

That is not the intention of this work.

In a therapeutic setting, your dose is carefully calibrated to allow you to go inward while still maintaining awareness and a sense of safety. You are not being given a dose that pushes you into that level of disconnection.

The experience is designed to be introspective and supportive, not overwhelming.

A troche is a lozenge that dissolves slowly in your mouth, while an RDT (rapid dissolve tablet) dissolves more quickly. Both are absorbed through the tissues of the mouth, allowing the medicine to take effect in a controlled and supportive way.

In my practice, I typically recommend troches. Troches are also less bitter and can be more precisely adjusted, allowing for more personalized dosing. Because they dissolve more gradually, they tend to create a longer, smoother experience rather than a quick peak in the first 15 minutes. Many clients find this slower, more gradual onset often supports a deeper sense of safety and regulation, which can make it easier to stay present, open, and engaged with your experience.

Your dosage is personalized based on your health history, current medications, and treatment goals.

You’ll begin with a starting dose determined by your medical provider, and it may be adjusted over time based on your experience to ensure both safety and effectiveness.

This is a collaborative process. You are supported by your therapist, your medical provider, and your own internal awareness.

Unlike many traditional medications that stay fixed, ketamine dosing can be more flexible within a safe range. Your care team will guide you within that range, and over time, as you become more familiar with the medicine, you may begin to notice a clearer sense of what feels supportive for your system.

Different doses can create different experiences. Lower doses may feel more subtle and reflective, allowing for gentle insight and emotional processing. Higher doses can bring a more immersive, inward journey where you may feel more deeply removed from everyday thought patterns.

The goal is not to push intensity, but to find the dose that allows you to feel safe, open, and able to engage meaningfully with your experience.

Ketamine can open the door, but it’s the intention, support, and integration that shape what unfolds.

I bring both clinical training and lived experience into this work, creating a space that is grounded, intuitive, and deeply attuned to you.

This is not a one-size-fits-all program. It is a collaborative, personalized process where your inner healer leads, and I help guide the way.

Ketamine has been used safely in medical settings for decades. Like any medication, it can come with some side effects, but most are short-lived and manageable.

Common side effects may include:

• Nausea
• Dizziness or lightheadedness
• Increased heart rate
• Mild changes in blood pressure
• Feeling groggy or tired after the session

These effects typically resolve within a few hours.

If you are prone to nausea, you can take an over-the-counter anti-nausea medication beforehand, or your medical provider may prescribe something like Zofran during your evaluation to help prevent discomfort.

True allergic reactions are extremely rare. If they were to occur, they would include symptoms like hives, swelling, or difficulty breathing and would happen shortly after taking the medicine.

You will be carefully screened beforehand, and your care team will ensure this is a safe and appropriate option for you.

Many people come to this work after years of talk therapy, books and insight, still feeling stuck in the same patterns. It can be supportive for depression, anxiety, trauma and PTSD symptoms, looping thoughts, generational patterns and a harsh inner critic.

Your free consultation is the best place to explore whether it feels like a fit, and a physician always decides whether ketamine is medically appropriate for you.

The program moves through a steady rhythm: prepare, journey, integrate, and then again. It includes the Reimagine Healing course to walk you through every step, music journeys created by Sarah and by musicians, personalized guided meditations (to open your heart, lead with trust, access your boundaries, find your authentic self and remove the mask), two guided sessions with Sarah, six music-led journeys at home (as prescribed by your physician), integration calls, and the re:Embody app at no cost. Your first guided session is a psychedelic journey. Your second can be another psychedelic journey or a low-dose journey Sarah may recommend, guided throughout.

To protect your privacy, all support happens inside our sessions rather than through texting or messaging apps.

See the full program

The medicine is powerful. It brings the aha moments and the awakenings, opens the door to a new pathway, and often helps you feel better, held and supported, with a remembering of love and trust in yourself.

But it isn’t a magic pill. Without integration, that opening fades and we tend to drift back into old ways. That’s why the program moves through prepare, journey, integrate, twice, with integration calls and daily practices that help your new way of being take root. Ketamine is the assistant. The therapy, and the steps you take, are what make it last.

Because every path is a little different, Sarah shares the investment personally on your free 20-minute consultation, so you can make the choice that’s right for you, with no pressure.

• Sarah does not accept insurance.
• She can provide superbills, which you may be able to submit to your insurance for possible out-of-network reimbursement.
• HSA and FSA cards are welcome.

re:Embody will be available at a founders’ rate of $35/month, and it’s included for clients in the 4-month program.

As a self-pay client, you have the right to a Good Faith Estimate of your costs. Learn about your rights.

Your free consultation is virtual. Therapy and integration sessions can be in person at Sarah’s office in Winter Park, Florida, or virtual. Medicine journeys are part of a guided, at-home program, so you can journey in your own set and setting with Sarah’s support.

If you’d like, you can also add in-person journeys with Sarah for an additional cost.

Never stop or change medications on your own. Your physician reviews everything you take and decides what’s appropriate. In episode 107, Dr. Eric Milbrandt explains why many people don’t need to come off their psychiatric medications.

In episode 107, Dr. Eric, an addiction medicine physician, shares that in practice ketamine-assisted therapy usually doesn’t reactivate addiction, with one important exception: when ketamine itself was someone’s drug of choice. Your physician reviews your history carefully before anything begins.

Every client completes a medical evaluation with a physician, who decides whether ketamine is safe and appropriate for you. Let Sarah and your physician know if any of these apply to you:

• You are under 18 (ketamine-assisted therapy is only available to adults)
• You are pregnant or trying to get pregnant
• You have a history of psychosis or schizophrenia
• You are currently experiencing thoughts of harming yourself or suicidal intent
• You are currently experiencing acute mania
• You have a heart condition or cardiovascular concerns
• You have high or uncontrolled blood pressure
• You have a history of ketamine misuse or dependency
• You have a history of interstitial cystitis (IC) or bladder issues

Some of these may require additional medical evaluation and don’t automatically disqualify you. This helps ensure your safety and the most appropriate next steps.

If you are having thoughts of harming yourself, please don’t wait. Call or text 988 (Suicide & Crisis Lifeline) or call 911.

In low-dose sessions you keep the capacity to talk and to listen, and you’re always free to speak or stay quiet; your subconscious leads the way. Higher-dose journeys are music-led and inward, with no talking required.

For journeys at home, please make sure a trusted trip sitter is present for your session, and always follow your physician’s instructions for dosing and timing.

The medicine opens a window. Integration is how you walk through it. In the days after a journey, Sarah describes the brain as being “like warmed-up clay,” easier to mold, which is why journaling, breathwork, movement and integration sessions matter so much. It’s how new insight takes root in everyday life.

Many people love pairing past-life regression with a low dose of ketamine. It quiets the chatter of the mind so it’s easier to relax into a hypnotic state. It’s always your choice, and for Florida clients ketamine is prescribed by a physician. Learn about past-life regression

re:Embody is an integration companion. Sarah is your guide there, not your therapist, and using the app doesn’t create a therapist-client relationship. It supports you alongside your own provider, never in place of them, and it does not prescribe, provide or dose ketamine.

re:Embody is in its final stages for the Apple App Store and Google Play. Join the founders list to be among the first to know, with the founders’ rate of $35/month waiting for you.

Our next Soul Journeys retreat, A Journey of Remembering, is January 28–31, 2027 at the Atlantic Center for the Arts in New Smyrna Beach, Florida, hosted by Sarah and her mom, Petey Silveira. A 3-payment plan is available. See the retreat

The retreat page on Soul Journeys is private. Email Sarah at sarah@reimaginehealing.co for the password, then reserve your spot there.

Sarah is your therapist, not your prescriber. There are two routes:

• New to ketamine: after your free consultation, Sarah refers you to a trusted physician for a medical evaluation. If ketamine is right for you, the physician prescribes and monitors your medicine.
• Already working with a provider: if you already have a physician and a prescription, you can bring them with you, and Sarah works alongside your prescriber as your ketamine-assisted therapist.

Either way, your physician makes all decisions about medication and dosing. Ketamine-assisted therapy with Sarah is for Florida residents; if you live elsewhere, re:Embody is launching soon for anyone working with ketamine under a prescriber’s care.

Sarah is licensed in Florida, so her ketamine-assisted therapy program is for Florida residents. If you live elsewhere, re:Embody, Sarah’s companion app, is launching soon for anyone, anywhere, and trauma, inner child and coaching work may be available virtually. Reach out and we’ll help you find the right fit.

re:Embody holds music journeys, guided meditations for low- and high-dose journeys, breathwork, movement and integration practices, all recorded by Sarah. Never AI. It supports anyone working with ketamine therapeutically under a prescriber’s care. It does not provide or prescribe ketamine. Learn more about re:Embody.

Your free 20-minute consultation is a chance to connect with Sarah, share what’s bringing you here, ask questions, and feel into whether this path resonates. If ketamine-assisted therapy feels like a fit, the next step is a health review with a licensed medical provider.