Spravato vs. Ketamine: Which Is the Better Option for You?

Choosing between Spravato (esketamine) and IV ketamine can feel daunting, especially if you’re dealing with treatment-resistant depression. Both treatments offer rapid symptom relief, but the experience and effects vary greatly. Knowing these differences can help you decide which option aligns best with your needs, lifestyle, and treatment goals.

Both Spravato and IV ketamine are derived from the same parent drug—ketamine, which has been used as an anesthetic for decades. However, these treatments work in slightly different ways:

IV Ketamine: Administered via infusion, IV ketamine interacts with NMDA receptors, part of the brain’s glutamate system. It promotes neuroplasticity, helping the brain create new neural connections.
Spravato: Spravato contains esketamine, a more potent chemical variant of ketamine. It is delivered nasally and also targets NMDA receptors, offering similar antidepressant effects over time.
Key Takeaway: Both treatments stimulate neuroplasticity, which allows the brain to reorganize thought patterns and improve emotional regulation.

If you’re curious about the science behind these treatments, explore our blog on NMDA Receptor Modulation: The Science of Ketamine for more detail.

Anyone who has experienced both IV ketamine and Spravato will tell you that IV ketamine is a much more profound and immersive experience. Many patients report that ketamine induces a deeply altered state of consciousness—what some describe as a “dissociative journey”—that can feel intense yet therapeutic.

By contrast, Spravato offers a more controlled and predictable experience, focusing more on mood stabilization than on exploring altered states. This difference likely arises from their chemical composition:

• Ketamine: A mix of two enantiomers (mirror-image molecules), R-ketamine and S-ketamine, which together produce a broader range of effects.
• Spravato: Made only from S-ketamine, which offers a narrower and more targeted effect. The experience with Spravato is typically more manageable and milder, without the deeper introspective quality of IV ketamine.

At Therapeutic Infusions, we understand that every patient’s preferences vary. Some seek the transformative journey offered by IV ketamine, while others prefer the relative stability and predictability of Spravato. If you aren't sure what you're looking for, we can offer individual guidance at your consultation. You might also consider Psychedelic Coaching or Ketamine-Assisted Psychotherapy in Delaware

At Therapeutic Infusions, both treatments are delivered in calm, private rooms to ensure your comfort:

• IV Ketamine Experience:
  • Sessions are more immersive, with dimmed lights, eye masks, and noise-canceling headphones available to enhance relaxation.
  • The experience can feel like a dream-like state or out-of-body journey, often leading to new emotional insights.
  • Our team remains close by throughout the infusion to offer support and ensure your safety.
• Spravato Experience:
  • Sessions are more structured. You’ll self-administer the nasal spray under supervision and stay with us for two hours to monitor side effects like mild dissociation and dizziness.
  • Many patients prefer this more predictable approach for its focus on managing symptoms without intense dissociative effects.
  • While the experience is less immersive, the stabilizing effect on mood can still be profound.

• Self-administered as a nasal spray in a certified clinic.
• Requires two-hour post-treatment observation.
• Treatments begin twice weekly and taper to weekly or bi-weekly maintenance.
• FDA-approved, which makes it easier to get insurance coverage.

• Delivered through IV infusion, requiring close monitoring during the session.
• Sessions generally last about an hour with less post-treatment observation.
• Not FDA-approved for depression, so insurance coverage may be limited or unavailable.

Key Takeaway: Spravato offers more convenience and structure, while IV ketamine offers a deeper and more immersive therapeutic experience. Both have fast action and more potent effects than most other treatment options.

While both treatments are generally well-tolerated, they have different side effect profiles:

• Spravato:
  - Side effects may include mild dissociation, dizziness, and nausea.
  - These effects are temporary and usually resolve within a few hours.
• IV Ketamine:
  - Some patients experience intense dissociation, with shifts in perception or awareness.
  - Physical side effects may include blurred vision, elevated heart rate, and occasional nausea, but these wear off quickly.

At Therapeutic Infusions, we closely monitor patients during both treatments to ensure their comfort and well-being.

One of the most practical differences between the two treatments lies in cost and insurance coverage:

• Spravato:
  • FDA-approved, so many insurance plans cover part of the cost.
  • Out-of-pocket expenses depend on your coverage, with co-pays varying by plan.
• IV Ketamine:
  • Off-label for depression, so insurance coverage is often limited or unavailable.
  • Sessions typically cost between $300 and $800 each, with most patients requiring multiple treatments.

If insurance coverage is a priority, Spravato may be the more feasible option. However, IV ketamine may offer more profound relief, especially for those seeking faster symptom reduction.

Your decision will depend on several factors:

• Spravato might be right for you if:
  • You prefer a structured, milder experience with predictable effects.
  • Insurance coverage is essential to make treatment more affordable.
  • You are looking for ongoing maintenance with tapering sessions.
• IV ketamine may be the better choice if:
  • You seek a transformative, introspective experience to explore deeper emotional insights.
  • Rapid symptom relief is critical to your mental health.
  • You are comfortable with out-of-pocket expenses.

If you’re not sure which treatment is right for you, Therapeutic Infusions offers consultations to help you explore your options and create a personalized plan.

Both Spravato and IV ketamine are powerful tools for those struggling with depression, but each offers a different path to healing. Whether you prefer the immersive journey of IV ketamine or the steady stabilization of Spravato, Therapeutic Infusions is here to support you every step of the way.

Contact us today to schedule a consultation and find the treatment that works best for you.

This article is for informational purposes only and does not replace medical advice. Please consult with your healthcare provider before making any treatment decisions.