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Spravato vs. Ketamine | NeuroMend Ketamine Infusions

Ketamine vs. Spravato

Ketamine Treatments

Ketamine For Treatment Resistant Depression

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

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 they end up starting all over creating a vicious cycle of one failed treatment after another.


Esketamine and FDA approvals

With the success of ketamine infusions 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 TRD.

With the addition of this new medications patients now have the option to utilize either ketamine or esketamine treatments for their depression.

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Spravato FDA approved - NeuroMend Infusion Center

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.

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Ketamine vs Eskeramine - NeuroMend Infusion Center

Which treatment is right for me?

While having the option to choose between ketamine and esketamine as a treatment - its important to recognize that these can be more beneficial when addressing specific diagnoses. 

While studies show that ketamine can be a treatment for many diagnoses (including as a treatment for Complex Regional pain), esketamine has been FDA approved for major depressive disorder.

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.

Administration Time-frame

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.  

Medication Conjunction

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.

Treatment Time-Frame

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.

Insurance coverage

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.

Diagnosis Treated

Major Depressive Disorder

Obsessive Disorders


Anxiety Disorders

Neuropathic pains

FDA approved for major depressive disorder.



Spravato is 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

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Spravato is here - NeuroMend Infusion Center__

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.

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