What's the difference?
IV ketamine uses racemic ketamine delivered through an intravenous infusion, dosed and adjusted in real time by your provider. Its use for depression, anxiety, and PTSD is considered off-label and is supported by a substantial body of research.
Spravato is a branded nasal spray containing esketamine — one specific molecule derived from ketamine. It is FDA-approved for treatment-resistant depression and for depressive symptoms in adults with major depressive disorder and acute suicidal ideation, and it must be administered in a certified healthcare setting under a federal safety program (REMS).
How they compare
Delivery
IV ketamine: intravenous infusion. Spravato: nasal spray, self-administered under supervision.
Dosing control
IV allows precise, adjustable dosing during the session. Spravato uses fixed device doses.
FDA status
Spravato is FDA-approved for specific uses; IV ketamine for mental health is off-label but widely studied.
Setting
Both are given in-office with monitoring. Spravato requires a REMS-certified site.
Insurance
Spravato may be covered for approved indications; IV ketamine is often out-of-pocket.
Experience
Many clinicians find IV offers more flexibility to tailor the experience to the individual.
Which is right for you?
There's no universal "better" option — the right choice depends on your diagnosis, history, insurance, and how you respond. Some people are good candidates for one and not the other, and some try one after the other.
The honest answer
This decision should be made with a qualified medical provider who can evaluate your specific situation. Our practice focuses on IV ketamine therapy; if Spravato turns out to be the better fit for you, we'd rather you get the right care than the care we happen to offer.
IV Ketamine vs Spravato FAQs
Ready to talk it through?
Begin with a consultation. We'll review your history, answer your questions, and help you decide if IV ketamine therapy is right for you.
Book a Consultation — reach us your way.
Consultations are scheduled privately by phone and email — no online intake form.
Medical disclaimer. This page is for educational purposes only and does not provide medical advice, diagnosis, or treatment. Ketamine is used off-label for mental health conditions, is not appropriate for everyone, and individual results vary. Candidacy is determined only after a clinical evaluation by a licensed medical provider. If you are in crisis or thinking about harming yourself, call or text 988 or go to the nearest emergency room.