Understanding Your Ketamine Treatment Options

If you are exploring ketamine therapy for depression, you will likely come across two primary options:

  • Spravato (intranasal esketamine)
  • Intravenous (IV) racemic ketamine

Both are used to treat depression and related mood disorders, but they differ in how they are administered, how they are dosed, and how treatment is structured.

Understanding these differences can help you choose the right approach.

What Is Spravato?

FDA-Approved Esketamine Nasal Spray

Spravato is an FDA-approved form of ketamine therapy used for treatment-resistant depression. It contains only the S-enantiomer of ketamine and is delivered as a nasal spray in a certified clinic.

Treatment is provided under a federally regulated REMS program and is typically combined with an oral antidepressant.

What to Expect With Spravato Treatment

Spravato follows a fixed dosing protocol and relies on nasal absorption, which can vary between individuals.

Clinical trials showed benefit in some cases, while others did not demonstrate significant improvement over a placebo. As with any depression treatment, results vary from person to person.

What Is IV Ketamine Therapy?

Intravenous Ketamine for Depression Treatment

IV ketamine therapy uses racemic ketamine, which includes both the R- and S-enantiomers. It has been studied in psychiatric settings for more than two decades.

Treatment is delivered intravenously in a controlled, physician-present medical environment.

Why IV Ketamine Offers More Precision

IV administration allows for near-complete bioavailability and real-time dose adjustment during treatment.

This means your provider can tailor the experience based on your response, rather than following a fixed protocol.

A large body of research supports IV ketamine therapy for treatment-resistant depression, with many patients experiencing rapid symptom improvement.

Learn the Difference

Key Differences Between Spravato and IV Ketamine

Differences Spravato IV Ketamine

Treatment Method and Absorption

 Nasal spray with variable absorption Intravenous delivery with consistent absorption

Dose Control and Flexibility

 Fixed dosing schedule Real-time dose titration

Formulation

 S-enantiomer only R + S enantiomers

Clinical Experience

 Regulated clinic protocol Physician-guided, individualized care

Treatment Planning

 Standardized schedule Customized induction and maintenance

Why We Focus on IV Ketamine Therapy

A More Personalized Approach to Depression Treatment

WellCentric Health focuses exclusively on IV ketamine therapy delivered in a physician-present setting.

This allows us to provide:

  • Precise dose calibration
  • Consistent medication delivery
  • Flexible treatment planning
  • Individualized patient care

We believe that control, consistency, and clinical oversight are critical when treating complex mood disorders.

Rather than offering multiple treatment formats, we focus on delivering one approach with a high level of precision and accountability.

Choosing the Right Ketamine Treatment

What to Consider Before Starting Therapy

The best option depends on several factors, including:

  • Your diagnosis
  • Symptom severity
  • Previous treatment history
  • Safety considerations
  • Treatment goals

A consultation allows us to evaluate these factors and determine whether IV ketamine therapy is appropriate for you.

Frequently Asked Questions

Both treatments can provide benefits. However, intravenous ketamine administration allows greater dose flexibility and consistent absorption. We focus on IV racemic ketamine because of its pharmacologic precision and our clinical experience delivering it within a physician-present model.

Possibly. Treatment response can be influenced by dose, route of administration, induction structure, and maintenance planning. A structured reassessment can help determine whether a revised approach is reasonable.

Racemic ketamine contains both the R and S molecular forms of the drug. Spravato contains only the S form. The R molecule appears to play a significant role in ketamine’s antidepressant effect, which likely explains why Spravato consistently underperforms compared to IV racemic ketamine in both clinical settings and real-world outcomes.

Spravato performed inconsistently across its clinical trials, and many expected it to fail the approval process. The FDA Advisory Committee ultimately recommended approval based on the need for new options for treatment-resistant depression, not because the efficacy data were strong. That distinction matters when weighing your treatment options.

Spravato is FDA-approved only for treatment-resistant depression and major depressive disorder with suicidal ideation. IV racemic ketamine has a much broader evidence base, including anxiety, PTSD, OCD, chronic pain, and bipolar disorder, making it the more versatile option for patients managing more than one condition.

Yes. Spravato and IV racemic ketamine are not the same treatment. The difference in molecular composition, dosing precision, and route of administration means many patients who did not benefit from Spravato have responded well to IV ketamine. A consultation at Wellcentric Health can help determine whether it is a reasonable next step.

For most patients, IV racemic ketamine offers greater pharmacologic precision, more flexible dosing, and a stronger overall evidence base. A consultation at Wellcentric Health is the best way to evaluate your specific history and determine the most appropriate path forward.

Ketamine Therapy in Reno, NV

Start IV Ketamine Therapy with a Physician-Guided Approach

If you are considering ketamine therapy and want a more personalized, physician-guided approach, the next step is a one-on-one consultation.