Written by Austin Mao. Last updated October 2026. Educational only, not medical advice.
I have sat with all three. What matters, I have come to believe, is how long the experience lasts, who is with you, and what you are asking it to do.
This page lays out how ketamine, psilocybin and ayahuasca differ in plain language, and why Ceremonia works with two of them. Ceremonia does not offer ketamine. What I say about ketamine here is my opinion, and Ceremonia’s, on its efficacy and safety.
The short version
- Ketamineis a short, dissociative experience, usually given in a clinic or under a prescriber’s plan.
- Psilocybin is a several-hour experience that tends to ask you questions you did not know to ask. It is the medicine we work with in Awaken.
- Ayahuasca is a long, ceremonial experience that asks the questions and shows you the answers. It is the medicine we work with in Heal.
What each one is
Ketamine
Ketamine is a dissociative anesthetic that has been used in medicine for decades. In 2000, a small randomized, placebo-controlled trial of seven patients found that a single dose lifted depression within days (Berman et al., Biological Psychiatry, 2000). Today it is given by clinics as infusions or nasal spray. A form called esketamine (Spravato) was approved by the FDA in 2019, together with an oral antidepressant, for treatment-resistant depression, and it is given under direct observation with monitoring afterward. Ketamine blocks a receptor called NMDA, which is why people describe feeling detached from their body and thoughts.
Psilocybin
Psilocybin is the active compound in certain mushrooms. In the body it becomes psilocin, which acts on serotonin 2A receptors (Nichols, Pharmacological Reviews, 2016). Brain imaging in two groups of 15 volunteers showed decreased activity and connectivity in key hub regions, including parts of the default mode network, the brain’s pattern-keeping circuitry (Carhart-Harris et al., PNAS, 2012). I describe that network as the place where patterns like “don’t give your heart out too quickly” get stored. A small randomized, waitlist-controlled trial (27 adults) found psilocybin-assisted therapy reduced symptoms of major depression (Davis et al., JAMA Psychiatry, 2021).
Ayahuasca
Ayahuasca is a brew made from two plants. One is a vine, Banisteriopsis caapi, that contains a monoamine oxidase inhibitor. The other is a leaf, Psychotria viridis, that contains DMT. As I put it, the vine contains an MAO inhibitor “which allows your digestive system to process DMT. Without that… it would simply not work.” It has been used in Amazonian traditions for a very long time. A small randomized, placebo-controlled trial (29 people) reported rapid antidepressant effects in treatment-resistant depression (Palhano-Fontes et al., Psychological Medicine, 2019). More in the science on ayahuasca.
How the experience differs
Length
Rick Doblin, founder of MAPS, told me the question is less which medicine and more how long it lasts and how long you stay with the experience. “Imagine ketamine being a one-hour experience versus LSD being a twelve-hour experience. It gives your mind so much more space and capacity to process.” That is my recollection of the conversation, not a published finding.
With psilocybin, the medicine comes up over the first 30 to 60 minutes and begins to peak around one and a half to two and a half hours in. A second dose extends that peak. An ayahuasca ceremony typically lasts 4 to 6 hours, held at night.
Character
“Mushrooms ask you the right questions, the questions you haven’t known to ask yourself. Ayahuasca asks you the questions and gives you the answers.” With mushrooms you can look away. With ayahuasca, if you try to look away, the resistance builds in your body and you want to purge more, and then it washes through. Many people expect ayahuasca to be harder. In my experience it is often easier, because the resistance has somewhere to go.
Ketamine’s operative mechanism, as I see it, is dissociation. “You can pull apart from the things that were traumatic for you before to observe it.” That can be useful as an entry point. It can also become a habit of stepping away from what hurts, rather than meeting it.
What each is suited for
- Ketamine can be a fit for people working with a prescriber on treatment-resistant depression. That is a clinical decision, made with a physician.
- Psilocybin suits someone who wants to reset patterns, open emotionally, and learn to be with what comes up, with the sense that they guided themselves there.
- Ayahuasca suits someone ready for a deeper, more shamanic-level ceremony, usually after prior experience with a gentler medicine.
Comparison table
| Aspect | Ketamine | Psilocybin | Ayahuasca |
|---|---|---|---|
| What it is | Dissociative anesthetic | Mushroom compound (psilocin in the body) | Brew of a MAOI vine and a DMT leaf |
| Typical length | Roughly an hour of effects, longer with monitoring | Several hours; peak around 1.5 to 2.5 hours in | Typically 4 to 6 hours per ceremony, at night |
| Plain-language mechanism | Blocks NMDA receptors; detachment | Serotonin 2A activity; reduced activity in default mode network hubs | DMT made orally active by the vine's MAOI |
| Felt character | Detached, observing | Asks you the questions | Asks the questions and gives the answers |
| Usual setting | Clinic or prescribed program | Group or individual ceremony or session | Ceremony, at night |
| Physical side | Dissociation; monitoring needed | Generally mild; screening required | Often includes purging; medication screening essential |
| Our view | Short and dissociative; limited room to process and to feel inner safety. We do not offer it. | The medicine in Awaken | The medicine in Heal |
Why Ceremonia works with psilocybin and ayahuasca
I put a lot of weight on one idea: the medicine is a tool, and the thing doing the healing is you. “The wrong way is to look out there for something we feel in here… The right way is to realize that the medicine is you. That it’s inside of you.”
Awaken is psilocybin because I want that first experience to be one of self-empowerment. You guided yourself to that feeling. You did not need an outside force to get you there. It is also why I encourage people to do psilocybin before ayahuasca. When a very powerful external medicine does the work, it is easy to credit the medicine, the facilitator or the music rather than the capacity inside you.
Heal is ayahuascabecause for someone who has already met that inner capacity, the ayahuasca ceremony is a deeper, more shamanic-level tool. It is our second level for exactly that reason, and I am clear with people that it is “just a tool, and the acting mechanism of your healing is you, not the medicine, not the facilitator.”
Our view on ketamine’s efficacy and safety.I, and so Ceremonia, hold a view on ketamine, and the reasons I have given in different settings are consistent. Its operative mechanism is dissociation, and psilocybin and ayahuasca are better at wholeness, at bringing back the parts you have been pushing away. It is also a short experience, which gives the mind less room to process. And in a clinic model there is often a sharp limit to inner safety, the felt sense that you can meet what comes up inside you, because you shake hands with the people in the room and a couple of hours later you are all tripping together. I also do not believe that a single session works like “take a pill and you’re solved.”
That is our view, not medical advice. Ceremonia does not offer ketamine. If you are already working with a prescriber, talk it through with them.
How to choose
- Start with your question, not the molecule.
- Ask how long the experience will give you to process.
- Ask who is in the room and how inner and outer safety are built.
- If you have not worked with psychedelics in a ceremonial container, begin with psilocybin.
- Screen honestly. Medications and health history change what is safe. See screening and medications.
Sources
- Berman RM, Cappiello A, Anand A, et al. Antidepressant effects of ketamine in depressed patients. Biological Psychiatry, 2000;47:351-354.
- U.S. Food and Drug Administration. Spravato (esketamine) nasal spray prescribing information, approved March 2019.
- Nichols DE. Psychedelics. Pharmacological Reviews, 2016;68:264-355.
- Carhart-Harris RL, Erritzoe D, Williams T, et al. Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin. PNAS, 2012;109:2138-2143.
- Davis AK, Barrett FS, May DG, et al. Effects of psilocybin-assisted therapy on major depressive disorder: a randomized clinical trial. JAMA Psychiatry, 2021;78:481-489.
- Palhano-Fontes F, Barreto D, Onias H, et al. Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial. Psychological Medicine, 2019;49:655-663.