| Feature | IV Ketamine Infusions | Spravato® (Esketamine Nasal Spray) |
|---|---|---|
| FDA Status | FDA-approved for anesthesia; off-label for mood & pain | FDA-approved for treatment-resistant depression, suicidal ideation, and anxiety disorders |
| Derivative | Ketamine (IV form) | Esketamine (a ketamine derivative) |
| Administration | IV infusion in clinic | Nasal spray in REMS-certified clinic |
| Typical Uses | Depression, anxiety, PTSD, OCD, bipolar depression, chronic pain (CRPS, fibromyalgia, tdigeminal neuralgia, migraines) | Treatment-resistant depression, major depressive disorder with suicidal thoughts, and certain anxiety disorders |
| Onset of Relief | Hours to a few days | 2–4 weeks |
| Treatment Schedule | Mood: 6 infusions over 2–3 weeks Pain: 4–5 consecutive days | 2x weekly for 4 weeks, then weekly or biweekly maintenance |
| Session Length | Mood: 40–60 min Pain: 2–4 hours | 2+ hours (including monitoring) |
| Driving | Not allowed after treatment | Not allowed after treatment |
| Side Effects | Dissociation, nausea, dizziness, blurred vision | Similar side effects, often milder |
| Insurance Coverage | Sometimes covered; patient responsible for remainder | Generally covered by insurance |
| Effectiveness | 70–80% response in mood disorders; 50–70% in chronic pain | 50–60% response in mood disorders |
Ketamine & Spravato® FAQ – Quad Cities Ketamine & Wellness Clinic
What are Ketamine Infusions and Spravato®?
IV Ketamine Infusions: A form of ketamine given through an IV at sub-anesthetic doses. While FDA-approved as an anesthetic, its use for psychiatric conditions such as depression, anxiety, and PTSD is considered off-label.
Spravato® (esketamine nasal spray): A derivative of ketamine and the only FDA-approved ketamine-based treatment for depression. It is administered in a clinic under medical supervision along with an oral antidepressant.
How do they work?
Both target the NMDA receptor, restoring glutamate balance, enhancing neuroplasticity, and improving mood regulation.
What conditions do they treat?
Mood disorders: Depression, anxiety, PTSD, OCD, bipolar depression.
Chronic pain conditions: CRPS, fibromyalgia, trigeminal neuralgia, musculoskeletal pain.
Migraines: Chronic and treatment-resistant migraines, including status migrainosus.
How fast do they work?
Ketamine Infusions: Many patients feel better within a few hours to a few days.
Spravato®: Relief generally appears within 2–4 weeks.
What side effects should I expect?
Ketamine Infusions: Dissociation, dizziness, nausea, blurred vision, lightheadedness.
Spravato®: Sedation, dissociation, dizziness, nausea, increased blood pressure, and vertigo.
Side effects are usually short-lived. Both treatments share similar side effects, though they tend to be milder with Spravato®.
What is the treatment process?
Ketamine Infusions for Mood Disorders: Typically six sessions over 2–3 weeks, each lasting 40–60 minutes, with boosters as needed.
Ketamine Infusions for Pain: A series of 4–5 consecutive infusions over several days. Each session lasts 2–4 hours.
Spravato®: Administered in clinic twice weekly for 4 weeks, then tapered to weekly or biweekly maintenance.
For all treatments, patients are monitored in our clinic and cannot drive afterward.
Are there any eligibility or safety concerns?
Ketamine Infusions: Not recommended for those with uncontrolled hypertension, active psychosis, pregnancy, or uncontrolled substance misuse.
Spravato®: Must be administered in a REMS-Certified clinic like ours and cannot be taken home.
Which option is right for me?
Spravato®: FDA-approved, generally covered by insurance, designed for treatment-resistant depression.
Ketamine Infusions: Broader applications (mood and pain), rapid relief for some patients, and in some cases partially covered by insurance. Patients are responsible for costs not covered.
Our team will guide you through which option may be best based on your condition and history.
What is the cost of IV Ketamine & Spravato®?
- IV Ketamine Infusions for Mood Disorders: Costs range from $373–$575 per infusion depending on plan and discounts available. Some insurance will pay part of the cost; patients are responsible for anything not covered.
- IV Ketamine Infusions for Pain: Pricing varies depending on infusion length (2–4 hours) and protocol, typically $800-$1100 per infusion. Some insurances may offer partial payment. Patient is responsible for anything insurance does not cover.
- Spravato® (Esketamine): Typically billed to insurance for FDA-approved indications. Out-of-pocket costs depend on your plan’s deductible and copay. Many patients pay only a copay; others may have a higher coinsurance.
- Payment Options: HSA/FSA accepted. Flexible payment plans and VIP Membership packages available to offer even more savings.
Are these therapies safe?
Yes. Both are administered in a medical clinic by trained anesthesia and nurse practitioner providers. Safety monitoring and supportive medications are always available.
How effective are they long-term?
Ketamine Infusions: Many patients experience rapid improvement in symptoms with lasting benefits for days to weeks. Maintenance boosters are often used for ongoing relief.
Spravato®: Relief typically develops more gradually over weeks. Ongoing maintenance treatments help sustain improvements.
Comparing Effectiveness: Research suggests that IV ketamine may provide faster and, for some patients, more robust relief compared to Spravato®. Both have strong evidence for treatment-resistant depression, with Spravato® offering the advantage of FDA approval and broader insurance coverage.
How does this compare with traditional antidepressants?
Unlike SSRIs or SNRIs, which can take 1-2 months to work, ketamine and Spravato® can produce noticeable improvements within just a few days to one or two weeks. They provide new hope for patients who have not responded to standard medications.
What about long-term safety?
When administered in a controlled clinic setting, both treatments have a favorable safety profile. Side effects are typically mild and temporary. Long-term maintenance is possible under careful supervision.
