When it comes to treatment-resistant depression (TRD), intravenous low-dose ketamine infusions and esketamine nasal spray (Spravato®) provide alternatives to traditional antidepressant medications. Many people who have long struggled to find an effective treatment for their depression are finding relief from ketamine therapies.
Why are ketamine therapies effective?
The difference is in the chemical pathways affected by ketamine-based treatments when compared with conventional options. IV ketamine and Spravato both work by modulating the neurotransmitter glutamate rather than serotonin, creating a different – and much faster – response in many patients with depression. Keta Medical Center specializes in both IV ketamine and Spravato therapies. Our physicians work with each patient to help them figure out which treatment is best for them, but this article offers a good starting point to understand the unique benefits of each.
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, delivered in two different ways. While the drugs are related, their chemical compositions are distinct. Both IV Ketamine and Spravato have been shown to be extremely effective for treating depression, and at least one recent study shows no difference in efficacy between Ketamine infusions vs. Spravato. That being said, there are specific benefits to each method.
Spravato – Proven Effectiveness
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. Because it is FDA approved, there have already been several studies showing its effectiveness both in the short and long term. Patients report feeling the benefits almost immediately, as early as 24 hours after treatment, and the positive results have been proven to last. Even 5 years after treatment, patients report that their depression has been significantly reduced.
The table below shows results from one study. Using the Montgomery-Åsberg Depression Rating Scale (MADRS) patients reported that their levels of depression were reduced significantly and in a lasting way. Even 5 years later, their depression, on average, was mild as compared with the moderate and severe levels reported before receiving Spravato treatment.
Ketamine – Immediate Relief
Ketamine is a generic medication that was first developed as an anesthetic before its antidepressant capabilities came to light. It is not under patent, but using ketamine for treating depression is an off-label use of the drug that is not FDA-approved for that indication. Shown to be effective for treating depression, PTSD, anxiety, OCD, and other mental health conditions, the dosage concentration used in ketamine clinics is far less than a typical anesthetic dosage.
Some research suggests that IV ketamine requires fewer treatments than Spravato. Side effects were also equal. A study from Cambridge University showed that “Intravenous ketamine and intranasal esketamine showed similar response/remission in TRD patients but the number of treatments required to achieve response/remission was significantly lower with Ketamine infusions vs. Spravato.”
Balancing the pros and cons
Studies directly comparing ketamine and Spravato are unavailable and likely will not be conducted due to ketamine’s off-patent and off-label status. However, both medications have been studied for use in Treatment-Resistant Depression (TRD) and have shown favorable results. They share similar potential benefits and side effects, including dissociation, drowsiness, nausea, and increased blood pressure. Ultimately, the choice between the two should be made in consultation with a medical professional.
Find the Best Ketamine Treatment for You
The team at Keta Medical Center can help you decide whether Spravato or IV ketamine is the right choice for your condition and medical history.
Call or click to schedule a consultation with one of our offices today.
