Spravato vs. Ketamine Infusion Therapy: Key Differences Explained

For individuals struggling with treatment-resistant depression (TRD) and other severe mental health conditions, ketamine-based therapies have emerged as groundbreaking treatment options. Two of the most common approaches are Spravato (esketamine) and ketamine infusion therapy. While both treatments stem from ketamine, they differ in how they are administered, their regulatory status, effectiveness, and cost.

If you are considering one of these treatments, it’s essential to understand their differences to make an informed choice. In this article, we’ll break down Spravato vs. Ketamine Infusion Therapy, helping you determine which one might be right for you.

Understanding Spravato (Esketamine Nasal Spray)

Spravato is a nasal spray medication that contains esketamine, a derivative of ketamine. It was approved by the FDA in 2019 for individuals suffering from treatment-resistant depression (TRD) and major depressive disorder (MDD) with suicidal ideation. Unlike traditional antidepressants, which primarily target serotonin and norepinephrine, Spravato works by influencing the glutamate system, a key player in brain plasticity and mood regulation.

One of the primary advantages of Spravato is that it is an FDA-approved treatment, which means it has undergone rigorous clinical testing to prove its safety and effectiveness. However, because of its potential side effects—such as dizziness, dissociation, and increased blood pressure—patients must take it under medical supervision in a certified treatment center. The process involves administering the nasal spray while being monitored for at least two hours before being allowed to leave.

Since Spravato is regulated, it is often covered by insurance, making it a more affordable option for many patients compared to other ketamine treatments. It is also prescribed alongside a traditional oral antidepressant to enhance its effectiveness.

Understanding Ketamine Infusion Therapy (IV Ketamine)

Ketamine infusion therapy takes a different approach by delivering racemic ketamine (a mixture of R-ketamine and S-ketamine molecules) directly into the bloodstream via an intravenous (IV) drip. Unlike Spravato, which is limited to esketamine, IV ketamine utilizes both forms of the compound, potentially leading to stronger and faster antidepressant effects.

This treatment is performed in a medical clinic, where a patient receives a controlled dose of ketamine over 40 to 60 minutes. The advantage of IV ketamine is that it bypasses the digestive system, allowing for immediate absorption and a more rapid response. Many patients report feeling noticeable mood improvements within hours of their first session, which is much faster than most traditional antidepressants.

While ketamine infusions have shown significant success in treating depression, PTSD, anxiety disorders, and chronic pain, they are not FDA-approved for mental health treatment. This means they are considered off-label, making it harder to receive insurance coverage. As a result, many patients must pay out of pocket, making it a more expensive option.

Despite this, ketamine infusion therapy remains popular for those who need faster relief or who may not qualify for Spravato. It also offers flexibility, as different clinics may tailor the dosage and infusion schedule to the individual’s specific needs.

Key Differences Between Spravato and Ketamine Infusion Therapy

There are several factors that set Spravato and ketamine infusions apart, including how they are administered, their effectiveness, regulatory approval, and cost.

• Method of Administration: Spravato is a nasal spray that must be used under supervision in an approved clinic, whereas IV ketamine is delivered directly into the bloodstream through an infusion. The IV method allows for faster absorption and potentially more pronounced effects.
• Active Ingredient: Spravato contains only esketamine, which is a more potent form of ketamine, whereas IV infusions use racemic ketamine, a combination of both R- and S-ketamine. Some research suggests that racemic ketamine may have broader therapeutic effects.
• FDA Approval and Regulation: Spravato is FDA-approved, meaning it has been rigorously tested for depression treatment. IV ketamine, on the other hand, is not FDA-approved for depression and is considered off-label. This makes Spravato a preferred option for those who want a medically regulated treatment.
• Effectiveness and Speed of Relief: Both treatments are highly effective, but IV ketamine is known for its faster onset of action, with many patients feeling relief within hours. Spravato takes longer to show full effects and requires multiple sessions over several weeks.
• Cost and Insurance Coverage: Since Spravato is FDA-approved, it is more likely to be covered by insurance, making it a more cost-effective option for many patients. Ketamine infusion therapy, on the other hand, is typically paid out of pocket, with costs ranging from $400 to $800 per session, making it less accessible for some individuals.
• Duration of Treatment Sessions: A Spravato session requires patients to stay in the clinic for at least two hours after administration for monitoring. IV ketamine infusions last between 40 to 60 minutes, with a shorter recovery period afterward.

Final Thoughts

Both Spravato and ketamine infusion therapy are revolutionary treatments for treatment-resistant depression and other mood disorders. While they share similarities, their differences in administration, regulation, speed of relief, and cost can significantly impact which option is best for you.

If you prefer an FDA-approved, structured, and insurance-covered treatment, Spravato is a great option. However, if you need faster relief and don’t mind paying out of pocket, IV ketamine infusions may be the better choice.

Before making a decision, it’s essential to consult with a mental health professional to determine which treatment aligns best with your medical needs and financial situation. Both options offer hope for those struggling with depression, providing new possibilities for relief and recovery.