IV Ketamine vs. Spravato®: Which Treatment May Be Right for You?

When you've been living with depression for a long time, it's easy to wonder if you'll ever find a treatment that truly helps. If antidepressants haven't provided the relief you hoped for, you may be exploring other options and coming across treatments like IV ketamine and Spravato® (esketamine). At first glance, they can seem very similar and it can be difficult to understand what sets them apart.

The truth is that both are innovative depression treatment options, but they differ in important ways, including how they're administered, how they work, and who they may be best suited for. If you're comparing IV ketamine vs. Spravato, this guide will walk you through what to expect from each treatment so you can have informed, confident conversations with your mental health provider about the option that's right for you.

What Is Spravato®?

Spravato® treatment is an FDA-approved option for adults with treatment-resistant depression and, in certain cases, major depressive disorder with acute suicidal thoughts or behaviors. Unlike traditional antidepressants that primarily affect serotonin, Spravato® contains esketamine, which works by targeting the brain's glutamate system. This different mechanism of action may help strengthen communication between brain cells and support healthier mood regulation.

Spravato® is administered as a nasal spray in a comfortable clinical setting under the supervision of trained medical professionals. After each treatment, patients remain in the office for a monitoring period to ensure their safety before returning home. 

Spravato® is prescribed alongside an oral antidepressant and is always provided as part of a comprehensive, individualized treatment plan.

What Is IV Ketamine Therapy? 

IV ketamine is an intravenous infusion administered in a supervised clinical setting by trained medical professionals. Although ketamine has been used safely as an anesthetic for decades, it is also increasingly used in specialized mental health practices as an option for individuals with treatment-resistant depression. 

Because the medication is delivered directly into the bloodstream, IV ketamine for depression reaches the body quickly and is carefully monitored throughout the treatment session.

Unlike Spravato®, IV ketamine is not FDA-approved specifically for the treatment of depression. However, a growing body of clinical research supports its use for some individuals who have not responded adequately to traditional treatments. 

Before beginning IV ketamine therapy, providers perform a comprehensive evaluation to determine whether it is an appropriate option and closely monitor patients throughout each infusion to prioritize both safety and comfort.

How Do Spravato® and IV Ketamine Work?

When comparing Spravato® and ketamine, it's helpful to know that both treatments work differently than traditional antidepressants like SSRIs. Instead of primarily targeting serotonin, both affect the brain's glutamate system, which plays an important role in communication between brain cells. By supporting these pathways and encouraging the brain's ability to form new connections, both treatments may help improve mood and reduce symptoms of depression.

The primary difference is the medication itself. Spravato® contains esketamine, a specific form of ketamine delivered as a nasal spray. IV therapy, on the other hand, uses ketamine administered through an intravenous infusion. 

While the medications are closely related, both treatments require careful evaluation and professional medical supervision to help ensure they are safe and appropriate for each individual.

What Does Treatment Look Like? IV Ketamine vs. Spravato®

While Spravato® treatment and IV ketamine therapy are administered differently, both are designed to provide care in a safe, comfortable, and closely monitored outpatient setting.

Spravato®

During a Spravato® appointment, the medication is self-administered as a nasal spray under the supervision of trained medical professionals. After treatment, patients remain in a comfortable treatment room for approximately two hours so the care team can monitor them for side effects and ensure they are ready to go home. 

Because Spravato® can temporarily affect alertness, patients will need someone else to drive them home after each appointment. 

IV Ketamine

With IV ketamine therapy, the medication is delivered through an intravenous infusion while patients relax in a comfortable clinical environment. Throughout the session, trained staff monitor patients to support their safety and comfort. After the infusion is complete, patients spend a short recovery period in the office before being discharged.

No matter which treatment is recommended, both are provided under careful medical supervision with personalized care every step of the way. Your provider will help determine the approach that best aligns with your needs and treatment goals.

Who May Benefit from IV Ketamine vs. Spravato®?

When it comes to treatment-resistant depression treatment, there isn't a one-size-fits-all solution. The right option depends on several factors, including your symptoms, treatment history, medical history, and personal preferences.

Spravato® may be recommended for adults with treatment-resistant depression who are appropriate candidates for an FDA-approved esketamine treatment and are able to take it alongside an oral antidepressant. 

Others may be better suited for IV ketamine based on their individual clinical needs, previous treatment response, or other considerations identified during a comprehensive evaluation.

Rather than one treatment being universally better than the other, the goal is to determine which approach is most likely to help you achieve meaningful symptom relief. A mental health provider can guide this decision, answer your questions, and develop a personalized treatment plan that aligns with your unique needs and goals.

Why Personalized Care Matters 

Depression affects everyone differently, so it's no surprise that treatment looks different from person to person as well. A therapy that works well for one individual may not be the best fit for someone else. That's why a comprehensive psychiatric evaluation is an essential first step in developing a treatment plan that reflects your symptoms, medical history, previous treatment response, and personal goals. 

In some cases, the most effective approach may include a combination of psychotherapy, medication management, TMS, Spravato®, or IV ketamine. By working collaboratively with your provider, you can explore the options that best support your long-term mental health and overall well-being. 

How Advanced Psychiatry Helps Patients Explore Their Options

At Advanced Psychiatry, we believe that informed decisions lead to better care. Every patient begins with a comprehensive psychiatric evaluation, allowing our team to better understand their unique needs before making treatment recommendations. 

Depending on your situation, your personalized care plan may include IV ketamine, Spravato®, TMS, medication management, psychotherapy, or a combination of these evidence-based services. Throughout the process, our team is committed to providing compassionate guidance, answering your questions, helping you navigate your options, and supporting you every step of the way as you work toward lasting symptom relief.

Choosing the Right Path Starts with Understanding Your Options

IV ketamine and Spravato® have many similarities, but they also have important differences that may make one treatment more appropriate than the other depending on your individual needs. 

The best treatment decision is one that's made in partnership with an experienced mental health provider who understands your unique situation. By learning about your options and asking questions, you can take an informed step toward finding the approach that feels right for you. With personalized care and the right support, meaningful progress is possible.

Advanced Psychiatry is Here to Help You

At Advanced Psychiatry, we are here to answer your questions, walk you through the process, and support you every step of the way. We provide authentic and trusted treatment options for depression, PTSD, anxiety, and OCD to those in the Fort Wayne, Ann Arbor, Lansing, and Troy communities. 

If you are considering depression treatment, please reach out to schedule a consultation and learn more about how we can help you on your journey toward healing.