Spravato vs Ketamine: 7 Key Differences in Depression Treatment
Spravato vs Ketamine: The Top 7 Differences for Hard-to-Treat Depression Are you looking for Spravato vs Ketamine? Let’s dive in. When dealing with stubborn cases of depression, there are two medications that are often considered: Spravato and Ketamine. These medical treatments are held in high regard in severe cases of depression, particularly in circumstances where… Read more
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at PsychPlus
September 16, 2024

Spravato vs Ketamine: The Top 7 Differences for Hard-to-Treat Depression
Are you looking for Spravato vs Ketamine? Let’s dive in. When dealing with stubborn cases of depression, there are two medications that are often considered: Spravato and Ketamine. These medical treatments are held in high regard in severe cases of depression, particularly in circumstances where traditional antidepressants come up short.
So, what are these medications? This article discusses Spravato treatment, the 9 main differences between Spravto and Ketamine, and provides further information to help you make the best decision for treating your depression.
What is Spravato (Esketamine)?
Spravato, also known as esketamine, is a nasal spray upheld by the FDA in 2019 for treatment resistant depression. Unlike standard antidepressants that target serotonin or norepinephrine, Spravato works by changing the activity of the frontal cortex’s glutamate structure, particularly through NMDA receptors. This approach is made to offer faster relief, often within hours or days, making it a great solution for patients who require an urgent level of care.
Spravato is commonly taken in a regulated setting, with patients expected to remain at the clinic for about two hours after taking the medication. This guarantees that any secondary effects, such dizziness or dissociation, can be overseen in a safe and controlled environment. Because of Spravato’s unique methodology and FDA endorsement, it is considered a great advancement in the mental health space for those battling with treatment-resistant depression.
What Is Ketamine?
Ketamine has a long history as an anesthetic but is now also used off-label as a treatment for depression. Like Spravato, Ketamine focuses on the NMDA receptors in the cerebrum, prompting a quick stimulant impact. However, Ketamine is administered intravenously (or through an IV), to ensure exact measurements and retention. Ketamine and Spravto yield similar results but are most distinguishable to patients by how they are taken. The IV technique offers more control for the provider but is more invasive than nasal spray.
While not FDA-endorsed specifically for treating depression, Ketamine has gained support for its use in psychiatry through many studies proving its effectiveness, particularly for patients who have not responded to other treatments. Its ability to rapidly alleviate symptoms of depression, sometimes within hours, has made it a valuable tool in managing severe mental health disorders.
1. What Makes Spravato and Ketamine Similar?
Spravato and Ketamine alike target NMDA receptors in the brain, which play a crucial role in regulating mood. This shared mechanism helps explain why both treatments can be effective for patients who have not responded to traditional antidepressants. By regulating glutamate, which is a neurotransmitter, they help restore synaptic connections in the brain, leading to improved mood and cognitive function.
Although they provide the same function, Spravto and Ketamine are compounded differently. Spravato is a subordinate of Ketamine, known as esketamine, which is the S-enantiomer of Ketamine. This slight variety in sub-atomic design can create differences in the effects of each medication on unique individuals. This is why it’s important to consult a psychiatri
2. Who Is Eligible to Receive Spravato and Ketamine?
Eligibility for Spravato and Ketamine can vary based on several factors, such as the patient’s medical history, the severity of their depression, and previous treatment responses. Spravato is FDA-approved specifically for treatment-resistant depression and is typically prescribed to adults who have not found success with other antidepressants. To qualify for Spravato, patients usually need to have unsatisfactory results with two other antidepressant medications.
Eligibility criteria for Spravato and Ketamine differ because Ketamine is used off-label, allowing doctors more flexibility when prescribing it. Ketamine is often administered to patients with severe depression symptoms, PTSD, and chronic pain conditions. Depending on local regulations and the clinic’s protocols, you may need a referral from a specialist to be considered for a Ketamine perscription.
Both medications are approved for adults, with research on their use in adolescents or older adults being more limited. Additionally, patients must undergo a thorough medical evaluation to determine if they have any contraindications that could make these treatments unsafe.
3. When to Avoid Spravato and Ketamine
Both Spravato and Ketamine treatments come with specific contraindications that must be considered before starting treatment. Patients with a history of aneurysms, uncontrolled hypertension, or certain vascular conditions should avoid these treatments due to the risk of worsening these conditions. Additionally, individuals with a history of substance abuse may be at risk of developing a dependence on these medications, particularly Ketamine, which has a higher potential for misuse.
Due to the psychoactive effects of both medications, patients with certain psychiatric conditions, such as schizophrenia or severe bipolar disorder, may be advised against using them. The dissociative and stimulating properties of both Spravato and Ketamine can potentially worsen symptoms and exacerbate these conditions.
Understanding the risks is crucial when deciding between Spravato and Ketamine for treating depression. A healthcare provider must conduct a thorough assessment to ensure that the treatment’s benefits outweigh the potential risks, tailoring the approach to the patient’s individual needs.
4. Spravato vs Ketamine: How Do They Work in Cases of Severe Depression?
Spravato and Ketamine are unique in their innovative approach to treating severe depression, providing hope where traditional antidepressants have failed. Spravato, administered as a nasal spray, often delivers results within hours or days. It is believed to restore synaptic connections in the brain that have been damaged by chronic stress and depression, leading to improved mood and cognitive function.
Ketamine also offers nearly instant results compared to other treatment options, but the IV administration is more invasive and is unattractive to many patients. The comfort and convenience of Spravato nasal spray is typically more ideal. Both medicines can create a brief dissociative outcome, where the patient may feel disengaged from their environment.
In terms of effectiveness, studies have shown that both treatments can reduce depressive symptoms significantly. For some patients’ results are nearly instantaneous, especially when compared to traditional antidepressants. However, the duration of these effects can vary, with some patients requiring ongoing maintenance treatments to sustain the benefits.
5. How Does the Administration Process Vary Between Spravato and Ketamine?
The primary difference between these treatments is their administration process. Spravato is given as a nasal spray under supervision, requiring patients to stay at the clinic for two hours afterward. This allows healthcare providers to monitor for any immediate side effects and ensure the patient’s safety before they leave.
Ketamine is administered via an IV infusion, which typically lasts about 40 to 60 minutes. The debate between Ketamine infusions and Spravato often centers on convenience versus the need for clinical oversight, with each having its own advantages and disadvantages. Ketamine infusions are usually performed in a clinic or hospital setting, where the patient’s vital signs are closely monitored throughout the treatment.
While Spravato’s nasal spray is more convenient and less invasive, some patients prefer the controlled environment of a Ketamine infusion, where the dosage can be precisely adjusted based on the patient’s response. The choice between these two methods often comes down to personal preference, medical history, and specific treatment goals.
6. Spravato vs Ketamine: Which is More Effective for Depression?
Effectiveness is a large factor to consider when choosing the best treatment option for you. Studies have shown that both Spravato and Ketamine can be highly effective for treatment-resistant depression, though their efficacy can vary from person to person. The effectiveness of Spravato versus Ketamine depends on factors such as the patient’s medical history, the severity of their depression, and their response to the treatment.
Some research suggests that Ketamine infusions may provide faster relief, with certain patients experiencing significant improvements shortly after their first infusion. However, these effects can be temporary, often requiring frequent maintenance infusions to sustain the benefits. In contrast, Spravato’s effects might take longer to become noticeable but can provide longer lasting relief with fewer treatments.
Clinical trials have shown promising results for both treatments, with response rates ranging from 50% to 70% in patients with treatment-resistant depression. Nonetheless, individual responses can vary, and it may require some trial and error to determine which treatment is most effective for a particular patient.
7. What are the side effects of Spravato and Ketamine?
Both medications come with potential side effects that patients should be aware of before starting treatment. Spravato may cause dizziness, dissociation, increased blood pressure, and sedation, with these effects typically subsiding within a few hours. Some patients might also experience nausea, vomiting, or a sense of detachment from reality, which can be unsettling but is usually temporary.
FAQ’s:
Which is better: Spravato vs Ketamine?
Ketamine infusions can also lead to side effects such as nausea, increased heart rate, and potentially intense dissociative experiences. The choice between Spravato and Ketamine often comes down to personal preferences and circumstances. Spravato offers the convenience of a nasal spray, while Ketamine infusions provide precise dosage control in a clinical setting.
Is Spravato the same as Ketamine?
Spravato is a specific form of Ketamine, known as esketamine, and is administered as a nasal spray, unlike traditional Ketamine, which is typically given via IV.
What are the 3 main differences between Ketamine and Spravato?
The key differences between the treatments are the method of administration (IV infusion vs. nasal spray), the precision of dosage control, and the fact that Spravato is FDA-approved specifically for treatment-resistant depression, whereas IV ketamine is used off-label.
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