Spravato vs. Ketamine: Which Is Right for Me?

When it comes to treatment-resistant depression (TRD), intravenous low-dose ketamine infusions and esketamine nasal spray under the Spravato® brand provide an alternative to traditional antidepressant medications. 

The difference is in the chemical pathways used by ketamine-based treatments when compared with conventional options. Ketamine and Spravato work by modulating the neurotransmitter glutamate rather than serotonin, creating a different -- and much faster -- response in patients with depression. 

KETA Medical Center specializes in both ketamine and Spravato therapies. Contact our nearest location to discover more and which treatment option is right for you. 

Spravato vs. ketamine

Spravato (esketamine) and ketamine are similar medications in two forms of delivery. While related, their chemical compositions are distinct. Ketamine was first developed as an anesthetic before its antidepressant capabilities came to light. 

Using ketamine for treating depression is an off-label function of the drug, delivered in a dosage concentration that’s far below a typical anesthetic dosage. Ketamine is a generic medication that’s no longer under patent. 

Esketamine is derived from ketamine and is intended as an antidepressant treatment. Delivered in the form of a nasal spray, Spravato has an accompanying list of protocols for treatment as part of its Food and Drug Administration approval for use as a depression treatment. 

Balancing the pros and cons

Studies that make direct comparisons between ketamine and Spravato aren’t available and likely won’t be done, given ketamine’s off-patent and off-label nature. Each medication, though, has been studied in relation to use with TRD, and both produce favorable results. 

Since each drug shares the same potential benefits and side effects (including feelings of disassociation, drowsiness, nausea, and increased blood pressure), consider these factors before discussing your options with our specialist care advisors: 

Ease of administration

Spravato is self-administered, though in the presence of a medical practitioner. It’s as simple as using any nasal spray. Low-dose ketamine infusion requires a clinical setting and a trained provider skilled in intravenous (IV) delivery. 

Absorption rate

The medical provider sets Ketamine’s absorption rate since IV infusion introduces the medication directly to the bloodstream. Spravato isn’t evenly absorbed since the condition of nasal passages varies between patients. There may also be differences in the self-administration process. The nature of the nasal spray process could introduce variations in absorption with each use.

Bioavailability

The amount of medication reaching the bloodstream varies between delivery methods. This is called bioavailability. With Spravato, about 25 to 50% of the active ingredient in a dose makes it to the bloodstream for absorption. With IV infusion, 100% of the dose is bioavailable. 

The team at KETA Medical Center can help you decide whether Spravato or ketamine is the right choice for your condition and medical history. Call or click to schedule a consultation with one of our offices today.