Spravato (Esketamine) vs Ketamine: Understanding the Differences
What is Spravato (Esketamine)?
Spravato is the brand name for esketamine, a derivative of ketamine. Approved by the FDA in 2019, Spravato is specifically designed for treatment-resistant depression and depressive symptoms in adults with major depression.
Unlike ketamine, Spravato is a nasal spray, administered in a clinical setting under supervision. After treatment, patients remain at the clinic for about two hours for monitoring.
At its core, Spravato works similarly to ketamine: it targets the brain’s NMDA receptors, which are key players in mood regulation and neuroplasticity. By activating these receptors, Spravato helps the brain form new pathways, offering a chance to break free from entrenched patterns of negative thinking.
What is Ketamine?
Ketamine has been used in medicine for decades, originally as an anesthetic. In recent years, it has gained recognition as an off-label treatment for depression, anxiety, PTSD, and even chronic pain.
What I love about ketamine is how quickly it works. Unlike traditional antidepressants that can take weeks to kick in, ketamine often produces noticeable relief within hours or days. For many clients, it feels like a long-overdue exhale, creating space to reconnect with hope and clarity.
Ketamine is typically administered in several forms:
IV infusions (the most common method)
Intramuscular injections
Oral lozenges
Nasal sprays (compounded versions, distinct from Spravato, are sometimes used in clinics)
Each method has its own advantages, and the choice depends on your unique needs and goals.
Key Differences Between Spravato and Ketamine
Though Spravato and ketamine both affect the brain in similar ways, their differences are significant.
1. Approval and Regulation
Spravato: FDA-approved for treatment-resistant depression, often covered by insurance.
Ketamine: Used off-label for depression, PTSD, and anxiety, but not FDA-approved for these conditions, meaning insurance coverage varies.
2. Administration
Spravato: Administered as a nasal spray in certified clinics, with mandatory observation periods.
Ketamine: Administered via IV, injection, lozenges, or compounded nasal spray, offering more flexibility in delivery methods.
3. Cost and Accessibility
Spravato: Often more expensive but typically covered by insurance due to its FDA approval.
Ketamine: Generally more affordable, though costs can vary depending on the administration method and insurance coverage.
4. Effectiveness
Both therapies are effective for treatment-resistant depression, but research suggests that ketamine may work faster.
A study published in JAMA Psychiatry found that ketamine often provides relief within hours to days.
Spravato, by comparison, tends to take several weeks of regular treatments before patients experience significant improvement.
5. Side Effects
Both treatments share common side effects, including:
Dissociation
Dizziness
Nausea
Temporary increases in blood pressure
With Spravato, some patients report nasal or throat irritation due to the spray’s delivery method. Ketamine, especially when given via IV, can produce more intense dissociative effects, but these typically subside shortly after the session.
How Long Do the Effects Last?
One of the most frequent questions I hear is: How long will the benefits last?
The answer depends on many factors, including the severity of your depression, the dosage, and how well you integrate the therapeutic effects into your daily life.
Ketamine: Relief can last anywhere from a few days to several weeks after a session.
Spravato: Results may take longer to appear but often last for a similar duration.
Regular maintenance treatments or booster sessions may be recommended for sustained benefits.
Which Treatment is Right for You?
Choosing between Spravato and ketamine is a deeply personal decision, one that depends on your history, needs, and preferences.
If you’re seeking an FDA-approved treatment covered by insurance, Spravato might be a good fit.
If you’re looking for a more flexible approach, or if you’ve found IV infusions helpful in the past, ketamine could offer a broader range of options.
As a practitioner, my role is to help you navigate this decision with care, answering your questions and tailoring treatment to your unique journey.
Trusting the Journey Toward Healing
Whether you choose Spravato or ketamine, what matters most is creating a safe and intentional space for healing. These therapies aren’t just about quick fixes—they’re about clearing the emotional weight you carry, making room for new growth, and reconnecting you to your purpose.
Both Spravato and ketamine offer incredible possibilities for healing, but the real transformation comes from within. These therapies are tools to support your innate ability to heal and thrive.
If you’re ready to take the next step or simply want to explore your options further, I’d love to connect. Together, we can chart a path toward relief, clarity, and a life that feels more aligned with your true self. Feel free to reach out for a consultation or to learn more about how ketamine and Spravato might fit into your mental health treatment plan.