Depression affects over 280 million people worldwide. Meanwhile, 30% of people diagnosed with major depressive disorder experience treatment-resistant depression. This means they struggle to find relief (or find none at all) with traditional mental health treatments.
For those battling treatment-resistant depression, innovative solutions like Spravato™ (esketamine) and ketamine infusions offer renewed hope. But what’s the difference between these two therapies? And which one might be right for you?
What is Spravato?
Spravato is an FDA-approved esketamine nasal spray typically used for adults with treatment-resistant depression. Derived from ketamine, it isolates the S-ketamine molecule to provide a more accessible treatment option for eligible patients.
Unlike oral antidepressants, which can take weeks to show results, Spravato works within hours by targeting NMDA receptors in the brain. This process triggers the release of glutamate—a key neurotransmitter that helps rebuild neural pathways. Patients typically take Spravato in a controlled medical environment—such as with qualified practitioners in a safe and supportive environment at Bespoke Treatment—with each session lasting about two hours, including post-treatment monitoring. Because of its convenience and effectiveness, Spravato has become a popular option for those seeking relief from moderate depression.
What is Ketamine?
Ketamine has been used as an anesthetic for decades. However, its potential as a mental health treatment has emerged in recent years. Administered intravenously (IV) or intramuscularly (IM), ketamine infusions offer rapid relief for depression, PTSD, and other mood disorders. Unlike Spravato, ketamine consists of two molecules—R-ketamine and S-ketamine—giving it a broader spectrum of action.
Ketamine’s rapid antidepressant effects stem from its ability to induce dissociation and promote the growth of new neural connections. IV ketamine is delivered with 100% bioavailability, meaning the body absorbs all of the medication. This makes it particularly effective for patients with severe symptoms, as it provides quick and significant relief.
Spravato vs. Ketamine Infusion: Which is Right for You?
While both Spravato and ketamine infusions can be transformative, they serve slightly different purposes and patient profiles. Below, we take a closer look.
Bioavailability and Dosing Differences
Spravato has about 40% bioavailability, meaning that less of the active medication is absorbed into the system. Additionally, it is offered in fixed doses, which makes adjusting the dosage less flexible. In contrast, ketamine infusions are delivered with 100% bioavailability, ensuring the full dose is absorbed. This allows for personalized dosing based on the patient’s unique needs and responses, offering greater flexibility to optimize treatment outcomes.
Effectiveness for Acute vs. Moderate Depression
Spravato is best suited for individuals with moderate-to-severe depression and is often used for maintenance therapy. It provides a more convenient option for patients seeking gradual improvement over time. On the other hand, ketamine infusions are typically recommended for severe or acute symptoms, such as suicidal ideation, due to their rapid and robust effects. Due to the differences in appropriateness, it’s common for individuals to start off with a series of ketamine infusions and then use Spravato for maintenance therapy. However, it’s worth noting the use of each may vary from patient to patient and individual cases.
Treatment Goals
Spravato is often used as a maintenance therapy to sustain benefits, making it a suitable option for individuals with less severe conditions. In contrast, ketamine infusions, as stated above, provide immediate relief and are frequently used as a catalyst for deeper therapeutic work—such as the IOP (Intensive Outpatient Program) offered at Bespoke Treatment.
At Bespoke Treatment, we work closely with patients to assess their unique needs and determine the best approach. Whether you’re considering Spravato or ketamine infusions, our team is here to guide you toward the right solution.
If you’re struggling with depression that hasn’t responded to traditional therapies, Spravato or ketamine infusions could offer the hope you’ve been searching for. Contact our team at Bespoke Treatment today to find out if these therapies could work for you and your situation.
