Which is Better: Ketamine Infusions vs. Spravato

Feb 08, 2024
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If you're interested in understanding if Spravato is a better option than ketamine, read on. While both offer potential benefits, we'll explore why Spravato may be the preferred choice for many patients.

Which is Better: Ketamine Infusions vs. Spravato

Which is better: Ketamine infusions vs. Spravato? Every day, Axis Integrated Mental Health treats patients who wonder if Spravato is "as good" as Ketamine infusions. While many patients think that IV Ketamine is the best choice for treatment-resistant depression, Spravato has significant advantages. In this blog post, we'll explore six ways that Spravato treatment is superior to IV Ketamine and why you might want to consider it as a treatment option.

Ketamine Infusions vs. Spravato

Ease of Administration

One of the most significant differences between Ketamine infusions vs. Spravato is the method of administration. With Spravato, patients can self-administer the nasal spray under the supervision of a healthcare provider, eliminating the need for an IV line placement. For anyone afraid of needles, this convenience is undeniable. Depression patients are already nervous and anxious, and the thought of having an IV started on them can be very triggering.

Abuse Risk

Patient safety is always a concern when it comes to controlled substances. In the debate about Ketamine infusions vs. Spravato, the latter wins because it is more tightly monitored than Ketamine. Spravato is both FDA-approved and a part of the FDA Risk Evaluation and Mitigation Strategies (REMS) program. As a part of this, Spravato treatment centers must be registered with the REMS program and meet the requirements to become a certified treatment center. These requirements include monitoring Spravato patients in the treatment center and not allowing Spravato to leave the treatment center. These precautions not only create a safer treatment environment for patients but also decrease the abuse potential of this valuable medication. No such requirements exist for Ketamine infusions.

Side Effects

While both Spravato and IV Ketamine can have potential side effects, Spravato tends to cause fewer and milder side effects than IV Ketamine. IV Ketamine can cause injection site pain, temporary blurred vision, and more severe psychological side effects like dissociation and hallucinations. In contrast, Spravato may only cause mild nasal discomfort or a runny nose, which is less intrusive and easier to manage. Many patients report that Spravato feels more like a gently guided journey through their mind, whereas IV Ketamine feels like a much more aggressive experience.


Another benefit of Spravato is its affordability. IV Ketamine treatments can be expensive, especially when considering the cost of clinic visits and IV infusion time. In contrast, Spravato is covered by most major insurance companies, including Colorado Medicaid, Anthem/BCBS, United Healthcare, Aetna, Cigna, and even Medicare. Read our articles about Spravato costs and Ketamine costs for more details.

Spravato Savings Card Program

IV Ketamine will never be covered by insurance as it has been FDA-approved for safety for over 20 years. It takes hundreds of millions of dollars to get a secondary indication from the FDA and it's unlikely any pharmaceutical company would do this for a generic drug. Spravato, on the other hand, has a savings card program for commercially insured patients. With this program, patients typically pay $10/visit, and the savings card pays the rest of the costs. Annually, patients can earn up to $8,150 towards their deductible and copays after the first month of Spravato treatment. This is a huge advantage and makes it easier to afford other treatments.


According to a recent study and previous research, there is no difference in efficacy between Ketamine infusions vs. Spravato. Side effects were also equal. In another study from Cambridge, published in The Journal of Clinical Psychiatry, it was noted that "Intravenous ketamine and intranasal esketamine showed similar response/remission in TRD patients but the number of treatments required to achieve response/remission was significantly lower with Ketamine infusions vs. Spravato."

Which is better TMS or Spravato (Esketamine Nasal Spray)?

Currently, there are no research studies that compare TMS treatment head to head with Spravato. From our experience, however, it's the wrong question to ask. We've seen the best results and outcomes for healing and remission when patients combine both treatments. In both cases, increased neuroplasticity results in functional changes to the brain and synaptic growth, changing the connections between logic and emotion.

The Final Analysis Between Ketamine Infusions vs. Spravato

To answer the question of "which is better, Spravato vs ketamine", it's important to consider the time and resources of the patient. While Ketamine has a proven history for depression treatment, the emergence of Spravato presents compelling advantages that make it a superior choice for many patients. From its ease of administration and lower risk of abuse to the fewer side effects and affordability, Spravato is a better ketamine-derived option. Additionally, its Savings Card Program further enhances accessibility and affordability for patients, making Spravato a better option and a more viable long-term solution.

As healthcare providers dedicated to increasing accessibility to cutting-edge mental treatments to more people, it's crucial to stay informed about evolving treatment options like Spravato to ensure the best outcomes for our patients' mental health and well-being.

What a patient says

Given all of these reasons, is Spravato worth it? We believe the following patient's words say it better than we can.