{"id":46592,"date":"2024-09-23T06:29:00","date_gmt":"2024-09-23T06:29:00","guid":{"rendered":"https:\/\/psyclehealth.com\/?p=46592"},"modified":"2024-09-17T20:25:15","modified_gmt":"2024-09-17T20:25:15","slug":"spravato-vs-ketamine-infusion-which-is-better","status":"publish","type":"post","link":"https:\/\/psyclehealth.com\/psyclehealth-sta\/?p=46592","title":{"rendered":"Spravato vs. Ketamine Infusion: Which is Better?"},"content":{"rendered":"\n<p>Ketamine and <a href=\"https:\/\/psyclehealth.com\/psyclehealth-sta\/alternative-treatments\/what-is-spravato\/\" title=\"\">Spravato<\/a> (esketamine) have recently emerged as novel treatments for depression, showing fast and sustained results for treatment-resistant patients. This article will explore the differences between these two treatments, covering their effectiveness, side effects, and practical considerations like cost and administration.\u00a0<\/p>\n\n\n\n<p>Whether you&#8217;re exploring these options for yourself or a loved one, this guide will help you decide which treatment might be better for managing TRD.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Key Takeaways<\/strong><\/h2>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Both ketamine and Spravato are effective for treatment-resistant depression, with ketamine showing faster results, but studies suggest similar overall outcomes.<\/li>\n\n\n\n<li>Ketamine is given via IV infusion, while Spravato is a <a href=\"https:\/\/psyclehealth.com\/psyclehealth-sta\/lifestyle\/does-nad-nasal-spray-work\/\" title=\"\">nasal spray<\/a>. Spravato is FDA-approved and more likely covered by insurance.<\/li>\n\n\n\n<li>Both have similar side effects like dizziness and nausea, but ketamine may cause more intense psychoactive effects, while Spravato\u2019s side effects are more predictable.<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Treatment-Resistant Depression: Prevalence and Impact<\/strong><\/h2>\n\n\n\n<p><\/p>\n\n\n\n<p>Major depressive disorder (MDD) affects millions globally, with rates continuing to rise. Standard treatment typically involves talk therapy and antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac), citalopram (Cipramil), and escitalopram (Cipralex).<\/p>\n\n\n\n<p>However, around 30-40% of people with depression do not respond to these treatments, known as treatment-resistant depression (TRD). The <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10503923\/\" target=\"_blank\" rel=\"noopener nofollow\" title=\"\">FDA defines TRD <\/a>as a \u201cfailure to respond to two or more antidepressant regimens despite adequate dose and duration and adherence to treatment.\u201d<\/p>\n\n\n\n<p>TRD significantly impacts both individuals and society, contributing to emotional distress and substantial economic costs. TRD <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33989464\/\" target=\"_blank\" rel=\"noopener nofollow\" title=\"\">cost the US healthcare system<\/a> an estimated $43.8 billion in 2019.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Ketamine: A Breakthrough in Depression Treatment<\/strong><\/h3>\n\n\n\n<p>Ketamine was originally developed as an anesthetic but has gained recognition as a potent antidepressant over the past decade. In the year 2000, researchers conducted the <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/10686270\/#full-view-affiliation-1\" target=\"_blank\" rel=\"noopener nofollow\" title=\"\">first randomized controlled trial<\/a> showing ketamine had fast-acting and sustained benefits for patients with depression. Since then, multiple studies have highlighted ketamine\u2019s powerful antidepressant effects, including for those with TRD.<\/p>\n\n\n\n<p>Ketamine differs from traditional antidepressants like SSRIs through its unique interaction with NMDA receptors (more below). While SSRIs can take weeks to show effects, ketamine can reduce symptoms in hours, making it a promising option for those with severe depressive symptoms, such as suicidality. Moreover, whereas conventional antidepressants are taken every day, the antidepressant benefits of ketamine can last from several days to weeks.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Esketamine (Spravato): A Practical Alternative to Ketamine<\/strong><\/h2>\n\n\n\n<p><\/p>\n\n\n\n<p>Esketamine is the S-enantiomer of ketamine, meaning it is one of two mirror-image molecules that make up ketamine. It is more potent than R-ketamine (the other enantiomer) in blocking NMDA receptors (more below). This allows for smaller doses to be used, supposedly decreasing the risk of side effects.<\/p>\n\n\n\n<p>Johnson &amp; Johnson\u2019s Janssen Pharmaceuticals developed Spravato, which is esketamine as an intranasal spray, around 2010. Spravato was approved as a licensed treatment for depression by the FDA in 2019.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Dosing and Administration&nbsp;<\/strong><\/h2>\n\n\n\n<p><\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Ketamine Infusion&nbsp;<\/strong><\/h3>\n\n\n\n<p>The dosing for a ketamine infusion typically begins with a starting dose of 0.5 mg\/kg, which is administered over 40 minutes. Doses may be adjusted incrementally based on the patient\u2019s response and tolerability, with some protocols increasing the dose by 0.1 mg\/kg as needed.<\/p>\n\n\n\n<p>The number of sessions required during the ketamine infusion process will vary depending on the person. Ketamine infusions may be given as a standalone or a course of treatment. Patients receiving ketamine infusions for TRD typically receive around six doses over several weeks.&nbsp;<\/p>\n\n\n\n<p>Ketamine is most commonly administered intravenously, injected into a patient&#8217;s veins to reach the bloodstream and have an instantaneous effect. This administration occurs in a closely monitored clinical setting so that healthcare providers can monitor vital signs such as blood pressure and heart rate during infusions.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Esketamine<\/strong><\/h3>\n\n\n\n<p>Spravato is a nasal spray device that typically contains two doses. The starting dose for adults with TRD is generally around 56 mg. However, like ketamine infusions, the doses may be adjusted based on the patient\u2019s response.&nbsp;<\/p>\n\n\n\n<p>Spravato is usually taken twice a week for four weeks, and after this initial period, the dose may be reduced to once a week. Spravato is also taken under a doctor\u2019s supervision at a medical facility so patients can be monitored for side effects.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Mechanism of Action<\/strong><\/h2>\n\n\n\n<p><\/p>\n\n\n\n<p>Both ketamine and Spravato block NMDA receptors in the brain, which respond to the neurotransmitter glutamate. Through blocking inhibitory NMDA-mediated pathways, ketamine can increase glutamate release. This, in turn, may activate brain networks associated with mood regulation.<\/p>\n\n\n\n<p>Both drugs increase the amount of BDNF (brain-derived neurotrophic factor) through their action at NMDA receptors. BDNF supports the survival and growth of nerve cells, potentially helping repair damaged neural circuits.&nbsp;<\/p>\n\n\n\n<p>Esketamine binds more strongly to NMDA receptors than ketamine, and hence, lower doses are required to produce an antidepressant effect.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Comparing Ketamine and Spravato: <\/strong><strong>Efficacy and Safety Considerations<\/strong><\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"526\" src=\"https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-3-1024x526.png\" alt=\"Comparing Ketamine and Spravato\" class=\"wp-image-46602\" srcset=\"https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-3-1024x526.png 1024w, https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-3-300x154.png 300w, https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-3-768x394.png 768w, https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-3-1536x789.png 1536w, https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-3-2048x1052.png 2048w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Efficacy<\/strong><\/h3>\n\n\n\n<p>In an <a href=\"https:\/\/www.cambridge.org\/core\/journals\/cns-spectrums\/article\/comparative-effectiveness-of-intravenous-ketamine-and-intranasal-esketamine-in-realworld-setting-among-patients-with-treatment-refractory-depression\/F331E788C869F0FC81DF82DA35449776\" target=\"_blank\" rel=\"noopener nofollow\" title=\"\">observational study<\/a> from Cambridge University, researchers compared the outcomes of TRD patients who had either Spravato or intravenous ketamine. Those with intravenous injections had slightly better symptom improvements and higher remission rates. However, there was no significant difference between the two.&nbsp;<\/p>\n\n\n\n<p>Another <a href=\"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/fullarticle\/2792407\" target=\"_blank\" rel=\"noopener nofollow\" title=\"\">study from Yale University<\/a> directly compared reductions in depressive symptoms between ketamine infusion and Spravato. Remission rates and overall reduction in depression scores were similar between the two groups. However, secondary outcomes, including the patient&#8217;s quality of life, were higher for the infusion group.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Safety<\/strong><\/h3>\n\n\n\n<p>Ketamine and Spravato share the same <a href=\"https:\/\/psyclehealth.com\/psyclehealth-sta\/alternative-treatments\/ketamines-side-effects\/\" title=\"\">side effects<\/a>, including dizziness, nausea, dissociation, increased heart rate, and blood pressure. Both ketamine and esketamine also carry a risk for substance abuse, given the desirable psychoactive effects of the drug and the build-up of tolerance that occurs with repeated high doses.\u00a0<\/p>\n\n\n\n<p>Side effects specific to ketamine infusions include injection site pain, and generally, the psychoactive effects tend to be more intense as a higher dose is used. Esketamine may cause nasal blockage and discomfort.&nbsp;<\/p>\n\n\n\n<p>Spravato doses tend to be more controlled than ketamine infusions, so side effects may be more predictable and can be better managed. However, there is very little data directly comparing the side effect profile of the two treatments.&nbsp;<\/p>\n\n\n\n<p>&nbsp;In <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7704936\/\" target=\"_blank\" rel=\"noopener nofollow\" title=\"\">one study review<\/a>, more patients dropped out of esketamine trials because of adverse effects compared to patients who received ketamine infusion. In <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35416105\/\" target=\"_blank\" rel=\"noopener nofollow\" title=\"\">another study review<\/a>, the researchers concluded that ketamine infusions, but not Spravato, have a risk for impaired cognitive function.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Patient Perspectives<\/strong><\/h2>\n\n\n\n<p><\/p>\n\n\n\n<p>The preference between intravenous ketamine and esketamine will be completely dependent on the patient.&nbsp;<\/p>\n\n\n\n<p>If patients are scared of needles, they may have a preference for using Spravato rather than intravenous ketamine. However, if they are looking for a more rapid relief, intravenous ketamine could be a better option.&nbsp;<\/p>\n\n\n\n<p>Forum site users often describe ketamine to be a more intense experience than esketamine. So, for those curious about their mind and exploring consciousness, intravenous ketamine could be a preferable option.&nbsp;<\/p>\n\n\n\n<p>Want to try ketamine therapy?&nbsp;<a href=\"https:\/\/betteru.pxf.io\/c\/4724206\/1958053\/23850\" target=\"_blank\" rel=\"noopener nofollow\" title=\"\">Head over to BetterU<\/a>&nbsp;and&nbsp;<strong>get $50 off with Psycle50 at checkout<\/strong>.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/betteru.pxf.io\/c\/4724206\/1958053\/23850\" target=\"_blank\" rel=\"nofollow noopener\"><img decoding=\"async\" width=\"1024\" height=\"341\" src=\"https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-2-1024x341.jpg\" alt=\"Banner ad\" class=\"wp-image-46599\" srcset=\"https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-2-1024x341.jpg 1024w, https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-2-300x100.jpg 300w, https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-2-768x256.jpg 768w, https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-2-1536x512.jpg 1536w, https:\/\/psyclehealth.com\/psyclehealth-sta\/wp-content\/uploads\/2024\/09\/Spravato-vs-Ketamine-Infusion-2-2048x683.jpg 2048w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" loading=\"lazy\" \/><\/a><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Regulatory and Legal Considerations&nbsp;<\/strong><\/h2>\n\n\n\n<p><\/p>\n\n\n\n<p>Both ketamine and esketamine Schedule 3 compounds, defined as having low potential for physical and psychological dependence.<\/p>\n\n\n\n<p>The FDA approves Spravato for treating depression, but ketamine has only been approved as an anaesthetic. This means ketamine is used \u201coff-label\u201d in depression treatment and has less stringent rules surrounding its use. Spravato, on the other hand, has a special program called the Risk Evaluation and Mitigation Strategy (REMS) which helps lower the risks of sedation, breathing problems, and misuse.&nbsp;<\/p>\n\n\n\n<p>Spravato\u2019s approval also means that, unlike ketamine infusions, <a href=\"https:\/\/psyclehealth.com\/psyclehealth-sta\/alternative-treatments\/is-ketamine-therapy-covered-by-insurance\/\" title=\"\">it can often be covered by insurance<\/a>, making it more cost-effective for patients.\u00a0<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Spravato vs Ketamine Infusion: Which is Better?<\/strong><\/h2>\n\n\n\n<p><\/p>\n\n\n\n<p>Spravato (esketamine) and ketamine are promising for treating depression, especially for those who haven&#8217;t found relief with other treatments. Intravenous racemic ketamine has shown better results in some studies. Yet, Spravato is easier to use and might have fewer psychological effects.&nbsp;<\/p>\n\n\n\n<p>Choosing between Spravato and ketamine should be a team effort with a healthcare provider. They will consider what&#8217;s best for you, your preferences, and your health. More research is needed to fully understand how these treatments compare safety and long-term effects.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>FAQs<\/strong><\/h2>\n\n\n\n<p><\/p>\n\n\n\n<div data-schema-only=\"false\" class=\"wp-block-aioseo-faq\"><h3 class=\"aioseo-faq-block-question\"><strong>How Does Ketamine Work to Treat Depression?<\/strong>\u00a0<\/h3><div class=\"aioseo-faq-block-answer\">\n<p>Ketamine treats depression by blocking NMDA receptors in the brain. This can increase the release of glutamate and pathways involved in neuroplasticity, the ability for the brain to re-organize. This could potentially repair neural circuits involved in depression and improve mood.&nbsp;<\/p>\n<\/div><\/div>\n\n\n\n<div data-schema-only=\"false\" class=\"wp-block-aioseo-faq\"><h3 class=\"aioseo-faq-block-question\"><strong>What are the Main Differences Between Ketamine and Spravato (Esketamine) in Terms of Administration?<\/strong>\u00a0<\/h3><div class=\"aioseo-faq-block-answer\">\n<p>Ketamine is typically administered intravenously in a clinical setting, while Spravato is a nasal spray that is also given under medical supervision but does not require needles.<\/p>\n<\/div><\/div>\n\n\n\n<div data-schema-only=\"false\" class=\"wp-block-aioseo-faq\"><h3 class=\"aioseo-faq-block-question\"><strong>Are the Side Effects of Ketamine and Spravato Similar?<\/strong>\u00a0<\/h3><div class=\"aioseo-faq-block-answer\">\n<p>Yes, both treatments can cause side effects like dizziness, nausea, and dissociation.&nbsp; Ketamine infusions may result in more intense psychoactive effects, while Spravato&#8217;s side effects are generally more predictable. There are also specific side effects related to the administration method, such as needle pain from ketamine infusions and nasal discomfort from Spravato.<\/p>\n<\/div><\/div>\n\n\n\n<div data-schema-only=\"false\" class=\"wp-block-aioseo-faq\"><h3 class=\"aioseo-faq-block-question\"><strong>Is Spravato Covered by Insurance?<\/strong><\/h3><div class=\"aioseo-faq-block-answer\">\n<p>Spravato is FDA-approved for treating depression, making it more likely to be covered by insurance, unlike ketamine, which is often used off-label and may not be covered. Top medical insurance companies, including Cigna, Aetna, BCBS, United Healthcare, and <a href=\"https:\/\/psyclehealth.com\/psyclehealth-sta\/alternative-treatments\/does-medicaid-cover-spravato\/\" title=\"\">Medicaid<\/a>, <a href=\"https:\/\/psyclehealth.com\/psyclehealth-sta\/alternative-treatments\/unraveling-the-mystery-does-insurance-cover-spravato\/\" title=\"\">all cover Spravato costs<\/a>.\u00a0<br><\/p>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Ketamine and Spravato (esketamine) have recently emerged as novel treatments for depression, showing fast and sustained results for treatment-resistant patients. This article will explore the differences between these two treatments, covering their effectiveness, side effects, and practical considerations like cost and administration.\u00a0 Whether you&#8217;re exploring these options for yourself or a loved one, this guide [&hellip;]<\/p>\n","protected":false},"author":32,"featured_media":46598,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[447],"tags":[460,462],"class_list":["post-46592","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-alternative-treatments","tag-ketamine","tag-spravato"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO Pro 4.9.9 - aioseo.com -->\n\t<meta name=\"description\" content=\"Ketamine vs. Spravato: Compare the effectiveness, side effects, and practical considerations of these treatments for treatment-resistant depression.\" \/>\n\t<meta name=\"robots\" content=\"noindex, nofollow, max-image-preview:large\" \/>\n\t<meta name=\"author\" content=\"Martha Allitt\"\/>\n\t<meta name=\"google-site-verification\" content=\"ohjeoPTRpAv1mqLSvJowABy5alopweS7aDygMZ2uI1s\" \/>\n\t<link rel=\"canonical\" href=\"https:\/\/psyclehealth.com\/psyclehealth-sta\/?p=46592\" \/>\n\t<meta name=\"generator\" content=\"All in One SEO Pro (AIOSEO) 4.9.9\" \/>\n\t\t<meta property=\"og:locale\" content=\"en_US\" \/>\n\t\t<meta property=\"og:site_name\" content=\"Psycle Health | Your resource for alternative &amp; psychedelic mental health treatments\" \/>\n\t\t<meta property=\"og:type\" content=\"article\" \/>\n\t\t<meta property=\"og:title\" content=\"Spravato vs. Ketamine Infusion: Which is Better? 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