Pre-session dosing behavior instructions

The manuals converge on the need for clear, pre-session communication of behavioural requirements before dosing, with staff checking that participants understand and follow those instructions. Across the extracts, this includes reinforcing safety-related expectations, reviewing restrictions before the dosing day, and using those instructions to standardise conditions and reduce preventable risk. They also overlap in several concrete areas. The manuals recommend limits on food and drink before ketamine, restrictions on alcohol, nicotine, psychoactive substances, and other non-prescribed substances before psilocybin or ketamine sessions, and review of medication-related rules, including PRN use, prescribed regimens, and washout or continuity requirements. Several sources also include day-of-session or post-dose behavioural agreements, such as remaining on site, observing driving or transportation restrictions, and contacting staff or emergency services if crisis concerns arise. The sources differ in emphasis and specificity. The ketamine-assisted psychotherapy record focuses on fasting, medication and food instructions, and the possibility of cancellation and fees if instructions are not followed. The KARE protocol places more weight on abstinence agreements, caffeine limits, continuation of prescribed opioid regimens, and avoiding new mental health interventions during the trial.