Ketamine vs. Spravato®: Understanding the Difference in Modern Depression Treatment
For individuals struggling with depression that has not improved with traditional medications, newer treatments like ketamine and Spravato® have created renewed hope. At Salado Creek Mental Health, we understand that patients and families often hear these terms used interchangeably — but they are not the same treatment.
While both ketamine and Spravato® are connected scientifically, there are important differences in FDA approval, safety monitoring, consistency, insurance coverage, and clinical oversight.
Importantly, Salado Creek Mental Health offers Spravato® (esketamine) treatment only. We do not offer IV ketamine infusions.
What Is Ketamine?
Ketamine was originally developed as an anesthetic medication and has been used in medical settings for decades. In recent years, ketamine has gained attention for its rapid antidepressant effects in some individuals with treatment-resistant depression.
Most psychiatric ketamine clinics provide ketamine through:
- IV infusions
- Intramuscular injections
- Oral or compounded formulations
However, ketamine itself is not FDA-approved specifically for depression treatment. When used for psychiatric conditions, it is considered an “off-label” treatment.
Because ketamine clinics vary significantly, treatment protocols, monitoring standards, dosing consistency, and provider oversight can differ from one practice to another.
What Is Spravato®?
Spravato is an FDA-approved prescription medication specifically indicated for:
- Treatment-resistant depression
- Major depressive disorder with acute suicidal thoughts or behaviors (when clinically appropriate)
Spravato® contains esketamine, a refined component of ketamine that was extensively studied in large clinical trials before receiving FDA approval.
Unlike general ketamine therapy, Spravato®:
- Is administered as a nasal spray
- Must be given in a certified medical office
- Requires structured safety monitoring
- Is part of a federally regulated REMS (Risk Evaluation and Mitigation Strategy) program
- Has standardized dosing and treatment protocols
Patients are monitored in-office after treatment to ensure safety and tolerability.
Why Salado Creek Mental Health Chose Spravato®
At Salado Creek Mental Health, patient safety, evidence-based care, and clinical consistency are central to how we practice.
We chose to offer Spravato® because it provides:
- FDA-reviewed clinical data
- Structured safety standards
- Standardized administration protocols
- Medical monitoring requirements
- Greater insurance accessibility for many patients
- Integration into comprehensive psychiatric care
Our team believes patients deserve treatments that are not only innovative, but also carefully monitored and grounded in evidence-based psychiatric practice.
Is Spravato® Safer Than Ketamine?
This is a nuanced question.
Both ketamine and Spravato® can have side effects, including:
- Dissociation
- Sedation
- Increased blood pressure
- Dizziness
- Nausea
However, Spravato® is delivered within a highly regulated framework that includes:
- Mandatory observation periods
- Certified treatment centers
- Standardized administration
- FDA oversight
- REMS participation requirements
Because IV ketamine clinics are not standardized nationally, patient experiences and monitoring protocols may vary significantly between practices.
Who May Be a Candidate for Spravato®?
Spravato® may be considered for adults who:
- Have not responded adequately to traditional antidepressants
- Continue struggling despite multiple medication trials
- Experience severe depressive symptoms affecting daily functioning
A comprehensive psychiatric evaluation is necessary to determine whether Spravato® is appropriate and safe for a specific individual.
What to Expect During Spravato® Treatment
At Salado Creek Mental Health, Spravato® treatments are provided in a supportive outpatient setting with clinical monitoring throughout the process.
Treatment typically involves:
- Psychiatric evaluation and medical review
- Insurance authorization when applicable
- Scheduled in-office treatment sessions
- Observation and monitoring after administration
- Ongoing follow-up with your psychiatric provider
Most patients require a structured treatment schedule initially, followed by maintenance treatments depending on clinical response.
The Bottom Line
Ketamine and Spravato® are related treatments, but they are not interchangeable.
While ketamine clinics often provide off-label treatments with varying protocols, Spravato® is an FDA-approved medication delivered within a structured medical framework designed specifically for depression treatment.
At Salado Creek Mental Health, we are proud to offer Spravato® as part of our commitment to accessible, evidence-based psychiatric care for the San Antonio community and patients across Texas through virtual and in-person services.
If you are interested in learning whether Spravato® may be appropriate for you, our team can help guide you through the evaluation process.
