Spravato vs. Ketamine Infusions: What You Deserve To Know

If you or someone you care about is exploring ketamine therapy for depression or other mood disorders, it’s important to understand that not all ketamine treatments are created equal. And while more clinics are now offering options like Spravato (esketamine), we believe it’s essential to understand how these treatments differ, because those differences can significantly impact results.

Let’s break it down.

What Is Ketamine? Understanding Racemic Ketamine vs. Esketamine (Spravato)

Ketamine, in its original form, exists as two mirror-image molecules, R-ketamine and S-ketamine, known as enantiomers. You can think of them like your left and right shoes. They may appear similar, but they’re not interchangeable. Try putting two left shoes on and you’ll quickly realize that subtle differences matter.

The ketamine used in nearly all of the early, groundbreaking research, research that demonstrated rapid, profound relief from depression, was racemic ketamine, which contains both mirror-image molecules. Over time, researchers have found that R-ketamine may be especially important for sustained antidepressant effects, with some studies suggesting it offers longer-lasting benefits and fewer side effects.

How Spravato (Esketamine) Differs From Ketamine Infusion Therapy

Spravato, by contrast, is only the S-ketamine half of the molecule. It’s delivered intranasally and was developed in part to allow pharmaceutical patenting and insurance coverage. While this has made the treatment more widely available, the effectiveness has not lived up to expectations.

Spravato’s performance in clinical trials was underwhelming. Out of three major short-term studies submitted to the FDA, two failed to show a significant benefit over placebo. Many clinicians and researchers were surprised it was approved at all. Approval came not because the results were impressive, but because of the pressing need for new options in treatment-resistant depression.

Clinical Opinions & Research Comparing Spravato & Ketamine Infusions

A national survey published in Ketamine Insights Weekly, polling hundreds of ketamine practitioners, found that:

• Over 70% of providers rated patient response to Spravato as “poor” or “fair.”
• The majority reported better outcomes with IV racemic ketamine.
• Many voiced concern that patients who fail Spravato might wrongly believe ketamine doesn’t work for them.

We’ve seen this firsthand: clients often come to us after trying Spravato, disheartened by the lack of results. When they receive racemic ketamine, administered in a calm, monitored clinical setting, the difference is often dramatic.

Why We Do Not Offer Spravato At Our Ketamine Clinic

Because of this, we do not offer Spravato. Our commitment is to provide only those therapies we believe to be the most effective and clinically sound for our paying clients. That standard guides every service we offer.

Takeaway: Choosing The Right Ketamine Therapy For Depression

Spravato may be the more visible or accessible option right now, but visibility doesn’t equal efficacy. If you or someone you love is considering ketamine therapy, know that not all ketamine is the same, and that treatment quality, environment, and the specific form of ketamine all matter.

True healing is too important to leave to half measures, literally.