The science behind 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 the (S)-enantiomer of ketamine.
Both medications are given under the direct supervision of trained healthcare providers.