In early 2019, the FDA approved esketamine (marketed as Spravato™) as an additional therapy option for the management of treatment-resistant depression. Like its parent compound, ketamine, Spravato aids in the restoration of synaptic connections in the brain, which is a different mechanism that what traditional antidepressants aim to target. Because of this, both ketamine and esketamine are able to provide robust and rapid relief for the symptoms of depression.  Ketamine and esketamine are very similar in nature, so it is important to understand exactly how they are similar and how they differ. Here are some facts to help you understand these two treatment options and which may be the best option for treating your depression.

Method of Administration

The biggest different—at least to the naked eye—is that esketamine is administered via nasal spray and ketamine is administered intravenously. Both drugs must be administered in a clinical setting by an experienced medical professional, and neither drug is available as a “take home” prescription.   Administered intravenously, 100% of the ketamine becomes available to the brain. Intranasally, esketamine is marginally less bioavailable to the brain.   

Molecular Structure

Now, let’s talk about the science side of things. Ketamine is composed of two mirror-image molecules known as R-ketamine and S-ketamine which exist together and spin in different directions. This is called a racemic mixture, and when this mixture is separated, each molecule on its own is called an enantiomer. For esketamine, the developers isolated the S-enantiomer, which is more potent and binds better to a certain brain receptor which is known to play a part in depression.  

How they Work

Research is still ongoing when it comes to exactly how and why these drugs provide such rapid relief from depression symptoms, but scientists believe that both drugs act as NMDA receptors. Ketamine and esketamine restore proper glutamate levels in the brain, which—in turn—establishes the correct balance of neurotransmitters needed for a healthy brain.   

Ketamine vs. Spravato – Head to Head

spravato vs. ketamine

Which Option is Best?

If you have additional questions about Spravato, or are curious about whether Spravato or ketamine is the best treatment for your depression, we are happy to offer guidance. We are one of few ketamine clinics to offer a completely free consultation to all new patients—and also one of few ketamine clinics to offer both IV ketamine and Spravato. Please ask us about Spravato for treatment-resistant depression or ketamine infusions for depression, anxiety, and other psychiatric disorders.

ketamine for depression

Contact Ketamine Greater Boston

Ketamine Greater Boston offers Spravato™ nasal spray and ketamine infusions for the treatment of depression, anxiety, PTSD, and other psychiatric conditions. If you are suffering from treatment-resistant depression and haven’t found a solution, ketamine could be what you’re looking for. Contact us for a free consultation today to learn more about ketamine infusions and find out if you’re a candidate.