Spravato (Esketamine) vs Ketamine Infusion Therapy: What Is the Difference?
Ketamine is a psychedelic drug with powerful antidepressant effects. When properly administered, Ketamine therapy can help with various health concerns. For example, it may relieve the symptoms of anxiety disorders, PTSD, depression, and chronic pain. In addition, research shows Ketamine achieves impressive outcomes by altering how the brain processes information1.
If you’re considering receiving Ketamine therapy, you should be aware of your options. There is a similar treatment called Spravato. Both treatments help with depression. But they do not have the same structure or treatment outcomes. One might be a better fit for you than the other. It is important to learn about the differences between Spravato and Ketamine infusion therapy. Once you do, you’ll have an easier time choosing the right one for your needs.
Ketamine Nasal Spray vs Ketamine Intravenous Therapy
Esketamine (marketed as Spravato) is an FDA-approved therapy for treatment-resistant depression. Like Ketamine infusion therapy, it can provide rapid relief from depression symptoms. Though these two drugs are similar in some ways, they differ in others. Here are a few things you should know about the differences between Spravato vs Ketamine infusion therapy.
Molecular Structures
Ketamine contains two molecules that are mirror images of each other. These molecules are called R-Ketamine and S-Ketamine. They spin in opposite directions but still exist together. This unique structure is referred to as a “racemic mixture.” When R-Ketamine and S-Ketamine molecules are separated from each other, each one is called an enantiomer.
In Esketamine medication, the S-enantiomer found in Ketamine is intentionally isolated. This is the more potent of the two molecules. It binds more effectively to a particular brain receptor associated with depression.
Methods of Administration
Method of administration is the most obvious difference between Spravato vs. Ketamine infusion therapy. Spravato comes as a spray that’s administered via the nasal passage. Ketamine intravenous therapy is administered through an IV. Neither of these drugs is available as a prescription that patients can take home. Each is a controlled substance that a qualified professional should only administer. They must also be administered in a clinical setting.
Ketamine infusion therapy is administered directly into the bloodstream. This means the medication has easy access to the brain. On the other hand, Esketamine may be marginally impacted in its ability to access the brain. This is because it is administered into the nasal cavity. But despite these differences, both types of therapy are still great for treating depression.
How They Work
Researchers are still trying to learn exactly how Ketamine and Esketamine work. It is a bit of a mystery how they provide such rapid relief from symptoms of depression. But the pervading theory is that both drugs act as NMDA receptors. NMDA receptors are proteins that receive signals from nerve cells. They play a key role in regulating many different neurological functions. One of those functions is to manage glutamate levels in the brain.
Glutamate is a neurotransmitter that can support optimal brain function. But it needs to be present in the proper amounts to do this. The antidepressant effects of Ketamine and Spravato likely stem from their impact on glutamate.
Comparing Results from Spravato vs Ketamine Infusion Therapy
In a Ketamine study, people with severe depression experienced a 47.2% reduction in their symptoms2. These exciting results occurred after 8-10 infusion sessions. Study participants also noted these benefits occurred without corresponding impairments in cognitive performance.
A randomized study of patients who received Esketamine also yielded positive outcomes. The severely depressed patients received Esketamine nasal spray3 treatments. Afterward, they experienced robust and rapid reductions in depressive symptoms.
When comparing Spravato vs Ketamine infusion therapy, keep in mind that the bioavailability of IV-administered Ketamine is 100%4. This means that the full amount administered to you will reach your brain. This is where it can have the biggest impact on your depression symptoms. Spravato, on the other hand, is estimated to have a bioavailability rate of only about 50%. Both drugs show great promise for improving depression symptoms. But Ketamine infusion therapy may be a better choice for some people.
Side Effects of Spravato
It isn’t uncommon for patients to experience mild side effects after Spravato treatments. These may include:
- Sleepiness
- Vertigo
- Nausea and vomiting
- Dizziness
- Dissociation
- Anxiety
- Fatigue
It’s important to note that these symptoms won’t affect everyone who takes this drug. Serious side effects are rare. But they can include allergic reactions, dissociation, and suicidal behaviors or thoughts.
Side Effects of Ketamine Infusions
Some patients may have transient adverse effects after Ketamine treatments. These typically subside within an hour of treatment5 and may include:
- Fuzzy or blurred vision
- Dizziness
- Floating sensations
- Mild hallucinations
- Lightheadedness
- Coughing
- Rapid heartbeat
These symptoms often subside soon after treatment. There is also a possibility some patients may experience rarer, but more severe symptoms. These might include respiratory depression, allergic reactions, or seizures. In case of any serious or lasting side effects, contact a healthcare provider immediately. Or seek emergency medical attention.
Choosing Between Spravato vs Ketamine Infusion Therapy
It can be challenging to know whether Spravato or Ketamine infusion therapy is right for your needs. You shouldn’t have to make this tough decision alone, though. Instead, consult with a trusted medical professional and familiarize yourself with the pros and cons of each option. You may also want to check with your health insurance to see available coverage options.
Most insurance policies don’t pay for Ketamine treatments. However, some may offer reimbursement after treatments. Some policies may also cover all or a portion of Spravato treatments.
Ketamine Therapy in Los Angeles
Ketamine Therapy LA offers Ketamine infusion therapy for patients with treatment-resistant depression. Dr. Sirak, MD, is a board-certified anesthesiologist here at our Ketamine clinic. He can analyze your case and recommend a type of therapy that will provide the best results for your unique situation.
If you’re ready to stop living with the crippling effect of depression and experience an improved outlook on life, consider Ketamine. It can help you retrain your brain to process information in a healthier way. Our offices are in Los Angeles, CA, and West Hollywood. Call us at (323) 650-9883 to schedule your consultation.
Sources:
1 https://www.scientificamerican.com/article/behind-the-buzz-how-Ketamine-changes-the-depressed-patients-brain/
2 https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-022-03789-3
3 https://pubmed.ncbi.nlm.nih.gov/32861217/
4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126726/
5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6767816/