With more than 16 million Americans affected by major depression, utilizing innovative treatments that provide better relief than conventional antidepressants is more essential than ever. Failure to treat depression increases the risk of drug and alcohol dependence and even suicide. 

Intravenous Ketamine Therapy is a safe and effective treatment option that offers hope to millions of patients suffering from treatment-resistant depression. With many different routes of administration (ROA), how the medicine enters the body, it is important to understand the differences in effects. Below we’ll explore the two most popular ROAs of ketamine: IV Ketamine Infusions vs. esketamine nasal spray AKA Spravato.

Before we compare ROAs, it is important to note the chemical differences between the medications. We infuse the racemic mixture of ketamine, which contains 50% R-Ketamine and 50% S-Ketamine, which are left and right shaped molecules. Esketamine (s-ketamine) is the left shaped of the pair. They appear to be comparable, but some studies have shown R-ketamine to be slightly more effective as an antidepressant. The more significant differences between racemic ketamine, more commonly known as just ketamine, and Spravato are not the molecules themselves, but the route of administration or ROA. Esketamine is only approved for nasal administration. We provide ketamine intravenously because the IV ROA offers a number of advantages, some of which we’ll discuss below.

Spravato – Ketamine Nasal Spray (Esketamine): Does It Work?

Although IV infusions of ketamine are a proven solution to treat the symptoms of major depressive disorder, researchers are looking at the impact of Spravato, or generically referred to as esketamine (a unique nasal ketamine inhaler), which is one of two molecules that comprise ketamine. One of the studies published in JAMA indicated that taking intranasal ketamine for depression may help rapidly improve symptoms. Spravato was recently approved by the FDA for the treatment of depression.

Intravenous Ketamine Infusion vs. Spravato Nasal Spray: Which Works Better?

More than 100 clinical trials conducted by leading medical institutions and universities have proven the efficacy of Intravenous Ketamine Infusion Therapy for the treatment of depression. When ketamine is administered via other ROAs, such as intranasally or nasal sprays, the results have not held up the same. In short, IV ketamine infusion offer more reliable relief from depression symptoms compared to ketamine nasal spray or Spravato AKA esketamine nasal spray.

IV Ketamine infusion deliver ketamine directly into the bloodstream so the bioavailability, amount of medicine that reaches the bloodstream and can be therapeutic, is 100%. IV infusions of ketamine are the only route of administration where 100% bioavailability is possible. When ketamine nasal spray or esketamine nasal spray, also known as Spravato, is administered on the other hand, the bioavailability varies widely and is typically 25-50%. There are several other hurdles the medicine must overcome before it can reach the bloodstream, such as a stuffy nose, variation in nasal cavities, allergies and other challenges of the sinus, etc. The results from intranasal ketamine or intranasal esketamine are, at best, unpredictable and less effective than intravenous ketamine. 

When given through the nose, the medication must be suspended evenly and in a fine mist. Then, the mist must evenly saturate the nostril’s mucous membranes. Furthermore, the spray has to be targeted accurately in order to land at the right spot and not run down the back of the patient’s throat and be swallowed. The delivery also has to be gentle enough to not get sneezed back out.

Additionally, the ketamine spray will deliver a mist that provides a concentrated dose of the medication over just a few seconds of contact with the nostril’s mucous membranes. It provides only very brief contact with the delicate and vital brain systems which need to be exposed to the medicine over an adequate amount of time in order to achieve the desired results.

When ketamine is administered through a nasal spray, as ketamine or esketamine, there are many uncontrollable variables, such as rate of absorption and continuity of care, whereas intravenous infusions of ketamine are gradual and precise, allowing for much more predictable and controllable outcomes. Ketamine Infusion Therapy enables safe and slow exposure to the drug for superior results in relieving symptoms of depression.

How to Get Ketamine Infusion Therapy

World-renowned ketamine treatment experts at Ketamine Clinics Los Angeles provide concierge-level ketamine infusion treatments to patients in Brentwood, Santa Monica, Venice, Beverly Hills, Culver City, South Bay, Manhattan Beach, Redondo Beach, Newport Beach, Playa Vista, Playa del Rey, Marina del Rey, other neighborhoods in Los Angeles, communities in Orange County, and other Southern California areas. We also treat patients from states outside of CA and even countries outside of the United States. If you’re searching for “ketamine treatment near me,” visit Ketamine Clinics of Los Angeles, the premier mental health treatment center specializing in intravenous ketamine infusion therapy. Contact us to learn more and to schedule your free phone consultation.