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Choosing Ketamine or Spravato for Mental Health Treatment: A Comprehensive Guide

Updated: Aug 23

August 1, 2024


Woman choosing Spravato or Ketamine

Dealing with mental health issues such as OCD, anxiety, depression, and PTSD can be incredibly challenging. Fortunately, there are innovative treatments available that offer hope and relief for many. Two such treatments are ketamine and Spravato (esketamine). In this article, we will review the benefits of choosing ketamine therapy for OCD, anxiety, depression, and PTSD versus choosing Spravato for major depression and suicidal ideations.


What is Ketamine?

Ketamine is a medication originally developed as an anesthetic for surgeries. Over time, researchers discovered that studies show its potential in treating psychiatric disorders. Ketamine therapy involves administering the drug in a controlled environment, often through an intravenous (IV) drip, but also as a nasal spray or oral formulations.


Ketamine Uses

Ketamine is used for various medical purposes, including:

  • Anesthesia during surgery

  • Pain management

  • Treatment-resistant depression

  • PTSD

  • Anxiety disorders

  • Obsessive-Compulsive Disorder (OCD)


Food and Drug Administration (FDA)

Many medications are prescribed off-label by healthcare providers, meaning they are used in ways not specifically approved by the FDA. This practice is quite common, as psychiatrists and other healthcare professionals often rely on emerging research and clinical experience to use these medications for conditions beyond their original indications. Off-label prescribing allows for flexibility in treatment and can provide patients with access to potentially beneficial therapies that may not yet have formal FDA approval for their specific condition. While off-label use can be highly effective, it is important for patients to discuss the risks and benefits with their healthcare provider. While Ketamine is approved by the FDA for anesthesia, it is also considered as an “off-label” FDA use for disorders such as anxiety, depression, OCD, PTSD, and other mental health conditions.


Ketamine Therapy: How It Works

Ketamine therapy works by targeting a different brain pathway than traditional antidepressants. It affects the neurotransmitter glutamate, which plays a crucial role in mood regulation and pain perception. This unique action makes ketamine effective for patients who have not responded to other treatments.


Benefits of Ketamine Therapy

1. Rapid Relief with Ketamine: One of the most significant benefits of ketamine therapy is its rapid onset. Unlike traditional antidepressant medications, which can take weeks to show effects, ketamine can provide relief within hours. This is particularly beneficial for those with severe depression.


2. Effective for Treatment-Resistant Conditions: Ketamine has shown effectiveness in patients who have not responded to other treatments. This includes people with depression, PTSD, and severe anxiety disorders.


3. Minimal Side Effects: While all medications come with potential side effects, ketamine is generally well-tolerated. Common side effects include dizziness, nausea, and mild hallucinations, which usually subside shortly after the treatment.


Ketamine Side Effects

It's essential to be aware of the side effects of ketamine, which can include:

  • Dizziness

  • Nausea

  • Elevated blood pressure

  • Temporary Dissociations

  • Disorientation


Who is Not a Good Candidate for Ketamine Therapy?

Ketamine therapy is not suitable for everyone. Individuals with certain medical conditions or a history of substance abuse may not be good candidates. It's crucial to consult with a healthcare provider to determine if ketamine therapy is right for you.


Is Ketamine Addictive?

Ketamine can be addictive if misused. However, when administered in a controlled, medical setting, the risk of addiction is significantly reduced because you are working with a healthcare professional to determine your dose and frequency. It's important to follow the prescribed treatment plan and guidelines provided by your healthcare provider as well as to discuss short term and long term effects of the drug.


Ketamine Overdose

An overdose of ketamine can lead to serious health complications, including respiratory issues and unconsciousness. Always follow the dosage instructions provided by your healthcare provider to avoid the risk of overdose.


What is Ketamine Prescribed For?

Ketamine is prescribed for:

  • Anesthesia during surgical procedures

  • treat depression

  • PTSD

  • OCD

  • Severe anxiety disorders


Effects of Ketamine

The effects of ketamine include rapid relief from depressive symptoms, reduced anxiety, and a general feeling of well-being. Some patients also experience mild dissociation or a "floating" sensation during treatment, which usually subsides quickly. It is unclear if long term use will cause an increase in interstitial cystitis, a problem found in those who abuse Ketamine.


Woman with psychiatrist choosing Spravato or Ketamine

Choosing Spravato (Esketamine) for Major Depression and Suicidal Ideations


What is Spravato?

Spravato is a nasal spray form of esketamine, a derivative of ketamine. It has been approved by the FDA specifically for treatment-resistant depression and acute suicidal ideations. Like ketamine, Spravato works by affecting the glutamate system in the brain.


Benefits of Spravato

1. Targeted Treatment for Major Depression: Spravato is specifically designed for individuals with major depressive disorder (MDD) who have not responded to at least two other antidepressant treatments.


2. Rapid Relief from Suicidal Thoughts: Clinical trial have shown that Spravato provides quick relief from mood disorders such as severe depressive symptoms and suicidal ideations, often within hours of administration. It is not approved for use with bipolar disorder.


3. Convenient Administration: Spravato is administered as a nasal spray in a medical setting, making it a more convenient option for those who may not be comfortable with IV therapy.


Spravato Side Effects

Common side effects of Spravato include:

  • Dizziness

  • Dissociation

  • Increased blood pressure

  • Nausea

  • Fatigue


Who is Not a Good Candidate for Spravato?

Spravato is not recommended by mental health professionals for individuals with a history of aneurysms, blood vessel disorders, or uncontrolled high blood pressure. As with ketamine, it’s essential to consult with a healthcare provider to ensure Spravato is appropriate for you.


Spravato vs. Ketamine: Which is Right for You?

Choosing between ketamine and Spravato depends on your specific condition and treatment history. Here’s a quick comparison:


  • Ketamine is versatile and used for a range of conditions, including OCD, PTSD, anxiety, and depression. It can be administered in various forms and provides rapid relief with minimal side effects.


  • Spravato is specifically approved for treatment-resistant depression and suicidal ideations. It offers quick symptom relief and is administered as a nasal spray for convenience.

Woman reading medicine label for Ketamine or Spravato

Conclusion

Both ketamine and Spravato offer hope for individuals struggling with severe mental illness problems. Ketamine works as a versatile option for various disorders, providing rapid relief for treatment-resistant conditions. Spravato is a targeted treatment for major depression and suicidal thoughts, offering quick and effective symptom relief.

Always consult with a healthcare provider to determine the best treatment option for your needs. With the right support and treatment plan, it’s possible to manage your mental health effectively and improve your quality of life.





Further Resources

Taking the step towards treatment is a significant move towards better mental health and well-being.

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