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Spravato vs. Ketamine - What You Need to Know

When you're on a seemingly endless journey through the maze of treatment-resistant depression, every new option that comes your way feels like a glimmer of hope. For those who have trudged through the muck of traditional treatments without finding relief, the emergence of Spravato and ketamine in the conversation might feel like a breath of fresh air. But, as with any new path, twists, turns, and decisions must be made. In this post, we'll dive deep into these two options, laying out the details so you can navigate this part of the maze more confidently.

What's The Difference Between Ketamine and Spravato

What's The Difference Between Ketamine and Spravato

Depression is a beast, plain and simple. For some, the standard arsenal of antidepressants can keep it at bay. Yet, for others, these treatments barely scratch the surface. This is where Spravato and ketamine step into the spotlight. Both have generated considerable buzz for their potential to provide relief where other treatments have not. But how do they stack up against each other?


Traditionally known for its use as an anesthetic in surgeries, ketamine has, in recent years, been hailed as a groundbreaking treatment for severe depression, especially for those who haven't found relief through other medications. Here's what makes it interesting:

  • Rapid Relief: One of the most remarkable aspects of ketamine is how quickly it can alleviate symptoms of depression, often within hours or days.

  • How It Works: Unlike traditional antidepressants that target the brain's serotonin system, ketamine affects the glutamate system, offering a different approach to brain chemistry.

  • Administration: Ketamine can be administered intravenously (IV) or through a nasal spray, making it flexible regarding treatment settings.

While its effectiveness in treating depression is notable, it's essential to mention that the use of ketamine for depression is considered "off-label." This means while the FDA approves it for use as an anesthetic, its use for depression doesn't have the same green light, which can affect insurance coverage and availability.


Enter Spravato (Esketamine), a close relative of ketamine and the new kid on the block in the world of depression treatment. Approved by the FDA specifically for treatment-resistant depression, Spravato offers a new avenue for those who've hit dead ends with other treatments. Here's the lowdown:

  • Targeted Treatment: Spravato is explicitly approved for use in treatment-resistant depression, providing a ray of hope for those who haven’t had success with other treatments.

  • How It's Administered: Spravato is a nasal spray, making it less invasive than IV treatments.

  • Speed: Similar to ketamine, one of Spravato's advantages is its ability to work quickly, offering potential relief in a shorter timeframe than many traditional antidepressants.

One notable aspect of Spravato is that because it's FDA-approved for depression, it's more likely to be covered by insurance, making it a more accessible option for some patients.

Pros and Cons of Ketamine and Spravato

So, we've looked at the similarities and differences, but how do you decide which, if either, is right for you? Let's break it down further.

Ketamine: The Pros

  • Rapid onset of symptom relief

  • Flexibility in administration methods

  • New hope for those who have tried everything

Ketamine: The Cons

  • Off-label use can complicate insurance coverage

  • Requires a clinic visit for administration

  • Longer-term effects and optimal treatment protocols are still under investigation

Spravato: The Pros

  • FDA-approved for treatment-resistant depression

  • Potential insurance coverage due to FDA approval

  • Rapid symptom relief

Spravato: The Cons

  • Can only be administered in a certified doctor’s office or clinic

  • Side effects can include dizziness, nausea, sedation, vertigo, and more

  • Long-term effects and efficacy are still being studied

Choosing between Spravato and ketamine

Choosing between Spravato and ketamine—or deciding to go another route entirely—is a deeply personal decision that should be made in consultation with your healthcare provider. Consider the following steps to guide your discussion:

  1. Evaluate Your History: Look back on what treatments you've tried and how they've worked for you. This history is crucial for making an informed decision moving forward.

  2. Consider Health Insurance Coverage: Unfortunately, the practicality of treatment options can often depend on what's financially feasible. Look into your insurance coverage to see what treatments are accessible to you.

  3. Weigh the Pros and Cons: Reflect on the pros and cons of each option. Consider the potential benefits, side effects, and practical aspects like treatment frequency and administration method.

  4. Think About Your Preferences: Ultimately, your comfort and preferences are critical. Which option feels more manageable to you? Which aligns better with your lifestyle and treatment goals?


Navigating treatment-resistant depression feels like wandering a maze with too many dead ends. Spravato and ketamine offer new pathways that might lead to a way out. While neither is a guaranteed escape route, they represent hope—a commodity that's often in short supply when you're battling depression.

When considering these treatments, the most important thing is to consult with your healthcare provider to thoroughly explore all your options. Whether you decide to pursue treatment with Spravato, ketamine, or another avenue entirely, the goal remains the same: finding relief and reclaiming your life from the shadows of depression.

Remember, treatment-resistant depression is a journey, but you don't have to walk it alone. With the right information and support, you can make informed decisions about your health and find the hope and healing you deserve.

More From Josh

About Josh Brar: 

Author - Josh Brar

Hello, I'm Josh Brar. My journey includes over 15 years in the pharmaceutical industry, which took an unexpected path in my 40s due to my struggle with treatment-resistant depression. Leveraging my pharmaceutical background, I gained extensive knowledge about mental disorders. Despite exploring numerous treatments, the challenge of finding relatable information and community support was significant. This inspired me to establish this platform, with the aspiration of it being a helpful resource for others on similar paths.



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