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Ketamine vs Esketamine (Spravato): What is the difference?

Sep 16, 2022 7:00:00 AM

Ketamine vs Esketamine Blog Featured Image - NeuroMend

Many patients are finding relief from treatment-resistant depression, PTSD and other chronic illnesses by utilizing ketamine to improve their symptoms.

Now with the FDA approved form of ketamine (Spravato or esketamine) hitting the market, many consumers are curious about the difference between the two.

Let's dive into everything you need to know about the difference between ketamine and Spravato.

  1. Ketamine for Treatment-Resistant Depression
  2. Esketamine and FDA Approvals
  3. The Science Behind Ketamine and Esketamine
  4. Ketamine vs Esketamine (Spravato)
  5. Spravato Savings Program
  6. NeuroMend is Spravato Certified

How Ketamine Relieves Depression ebook | NeuroMend

Ketamine For Treatment-Resistant Depression

Ketamine has begun to solidify its place in the treatment of Major Depressive Disorder (MDD) across the globe.

Studied for its ability to loosen repressed emotional trauma and improve the effects of psychotherapy (MDMA, LSD, Psilocibin) since the early 70’s, ketamine has evolved into one of the most novel treatments for MDD in this century.

Since 2006 ketamine has been studied more in-depth for the treatment of “Treatment-Resistant Depression (TRD)” with a success rate that has climbed as high as 80% or better for many patients who suffer with this debilitating disease.

Thousands of people are placed on antidepressants such as SSRIs, SNRI, and other widely prescribed medications that are ineffective in reducing depressive symptoms. Many of these medications take weeks to months for effects to be realized and often end up starting all over, creating a vicious cycle of one failed treatment after another.

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Esketamine and FDA approvals

With the success of ketamine therapy used intravenously seen across the nation, the creation of an FDA approved treatment was inevitable. In 2019 a nasal spray, esketamine, also known as Spravato, was approved for the treatment of Treatment-Resistant Depression.

With the addition of this new medication, patients across the nation now have the option to utilize ketamine or esketamine treatments for their depression.

The science behind ketamine and esketamine

For those interested in the science of ketamine and esketamine, continue reading.

(Click here to skip ahead to compare and contrast of ketamine and esketamine.)

Ketamine is a racemic mixture of two enantiomers that are mirror images of each other, S-ketamine (esketamine) and R-ketamine. Esketamine is the S (+) enantiomer of ketamine.

One of the enantiomers, S-ketamine (esketamine), binds more potently to the N-methyl-D-aspartate receptor than the other enantiomer, R-ketamine. Both enantiomers of ketamine have been researched but so far there is no conclusive evidence about which enantiomer is better for the treatment of mood disorders.

Spravato was created by taking the (S)-enantiomer of ketamine.

Both medications are given under the direct supervision of trained healthcare providers.

Compare and contrast: Ketamine vs Esketamine (Spravato)

Ketamine and esketamine are very similar in terms of their molecular structure, yet they do differ.

Let's dive into the details of both ketamine and esketamine, in terms of administration, dosage, bioavailability, administration time-frame, medication conjunction, treatment timeframe, and insurance coverage.


Ketamine is administered through an IV over a predetermined amount of time to slowly allow for the comfort and ease of transition into a relaxed state to enhance the cognitive effects of the treatment.
Spravato is self-administered over five to ten minutes in two to three successive intranasal sprays administered in five-minute increments.


The dose is determined by weight and titrated to effectiveness and comfort of the patient.

Spravato comes in two doses 56mg and 84mg.

Your healthcare provider will select the appropriate dose based on your response to the treatment.


The bioavailability of IV ketamine is 100%.

Meaning the dose that is given is the amount that will reach the brain.

Esketamine has a bioavailability of approximately 50%.

Things such as clogged nasal passages and swallowing part of the medication can affect the amount of medication that reaches the brain.


Ketamine is administered in six
treatments over the course of two to three weeks.

Maintenance booster infusions are often needed, and the frequency is individualized based on the response of the client. These boosters may be given once a month to two to three times a year.

Weeks 1 to 4: Spravato is administered twice a week for eight doses.

Weeks 5 to 8: Once weekly

Week 9 and after:Every 2 weeks or once weekly* 

*Dosing frequency will be individualized to the least frequent dosing to maintain remission/response.  


Ketamine can be administered in conjunction or as a single treatment for clients with MDD.
Spravato must be given in conjunction with an oral antidepressant.


IV ketamine treatment is approximately 1 hour and 15 mins to 1 and a half hours.
Spravato is a minimum of 2 hours after the initial dose is administered.


Currently insurance does not pay for the cost of ketamine treatment.

Your insurance provider may however reimburse you once treatment is received.

Your insurance may cover the cost of Spravato.

Your responsibility could be as little as $10 for each dose.

Spravato Savings Program

Janssen CarePath is now offering a new savings program for eligible commercially insured patients! Eligible patients can pay $10 per treatment for Spravato™ medication costs.

For more information on the Spravato Savings Program, how to apply and how to use, click "learn more" below!

Neuromend is SPRAVATO Certified

NeuroMend Infusion Center is a Risk Evaluation and Mitigation Strategy (REMS) facility, certified to provide SPRAVATO™ (esketamine), a nasal spray approved for use in conjunction with an oral antidepressant in adults with treatment-resistant depression (TRD).

People who are currently struggling with major depressive disorder (MDD) may have TRD if they have not responded adequately to at least two different antidepressants of adequate dose and duration in the current depressive episode.2

Which treatment is best for you?

Contact NeuroMend for further information to see which option will be best for your treatment.

Click here for inspiring, Spravato patient stories and reviews!

*Disclaimer: As of September 29, 2023, NeuroMend no longer offers Spravato treatments. We apologize for any inconvenience and encourage you to consult with our team or your healthcare provider for alternative options.

Leading Provider of Ketamine Treatments Free Consult | NeuroMend


neuromendicon2We are an Evidence-Based Center of Excellence and the leading provider of Ketamine Infusions, IV Infusions and Ketamine Consulting Services for Ketamine Clinics and IV Therapy Clinics.

We Provide Effective Treatment For The Following Conditions: Major Depressive Disorders, Post-traumatic Stress Disorder (PTSD), Bipolar Depression, Obsessive Compulsive Disorder (OCD), Chronic Migraines, Severe Anxiety, Fibromyalgia for Offering Spravato Esketamine

Neuromend Team

Written by Neuromend Team

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