Depression affects millions of people throughout the world, and while many find relief with medicines and psychotherapy, others suffer from treatment-resistant depression (TRD).

This has sparked interest in alternative treatments like Spravato (esketamine) and ketamine. While both seem to have potential, which one is better: Spravato vs Ketamine? Let’s find out.

What are the Differences Between Spravato and Ketamine Treatments?

Both Spravato and Ketamine have proven effective in treating TRD. However, their processes and outcomes vary. Here’s a thorough comparison of their effectiveness:

Method of Delivery

  • Ketamine: Ketamine is administered via an IV over 40 minutes, allowing precise control and enhancing the treatment’s cognitive effects.
  • Spravato: Spravato is self-administered with two to three intranasal sprays in 5-minute intervals, offering an alternative for patients who prefer to avoid an IV.

Treatment Schedule

  • Ketamine: Six ketamine infusions are given over 2-3 weeks. Many patients require maintenance booster infusions, the frequency of which varies based on individual response, ranging from once a month to twice a year.
  • Spravato: Weeks 1 to 4: Administered twice weekly for a total of eight treatments. Weeks 5 to 8: Administered once weekly. Week 9 and beyond: Administered every two weeks or as needed, depending on patient response.


  • Ketamine: The IV dose is adjusted based on the patient’s weight in kgs and titrated to ensure consistent, controlled, and, most importantly, comfortable delivery.
  • Spravato: Spravato comes in 2 doses: 56mg and 84mg. The prescribing healthcare provider will choose the appropriate dose based on the patient’s treatment response.


  • Ketamine: IV ketamine has a bioavailability of 100%, meaning the entire dose reaches the brain.
  • Spravato: The nasal spray has a bioavailability of approximately 50%, as some of the medication remains in the nasal passages or is swallowed, affecting the amount that reaches the brain.

Disorders Treated

  • Ketamine: Major depressive disorder, all types of TRD, PTSD, anxiety disorders, bipolar disorder, substance abuse.
  • Spravato: FDA-approved for major depressive disorder and acute suicidality.

Medication Requirements

  • Ketamine: Ketamine treatments can be administered alone, either independently or alongside psychiatric medications.
  • Spravato: Spravato requires administration in conjunction with an oral antidepressant.

Length of Appointment

  • Ketamine: The treatment typically lasts between 90 to 120 minutes.
  • Spravato: Lasts approximately 2 and ½ hours.

Spravato vs Ketamine: Which is More Effective for Depression?

Research comparing Spravato to Ketamine reveals mixed results. While one meta-analysis implies that ketamine is more effective than Spravato and has fewer adverse effects, a small study revealed similar results between the two.

Both medications are helpful in treating TRD, although consulting with a psychiatrist is important to assess the risks and benefits before choosing.

To Wrap Things Up!

Spravato and ketamine have emerged as effective choices for treating treatment-resistant depression, providing immediate relief to patients who have not responded to regular therapy.

If anti-depressants and counseling have left you feeling as if no treatment works for you. You may schedule an appointment with the skilled staff at Balanced Ketamine by dialing (913) 871-9888 to find out whether Ketamine infusion treatment might benefit you.

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