Ketamine vs. Spravato

Attribute	Ketamine	Spravato
Drug Class	NMDA receptor antagonist	Esketamine, NMDA receptor antagonist
Administration	Injected or infused	Nasal spray
Approved Uses	Anesthetic, off-label for depression	Treatment-resistant depression
Formulation	Generic	Brand name
Side Effects	Blurred vision, confusion, dizziness	Dissociation, sedation, blood pressure increase

Introduction

Ketamine and Spravato are two medications that are used to treat depression, particularly treatment-resistant depression. While both drugs are derived from ketamine, they have some key differences in terms of administration, dosage, and side effects. In this article, we will compare the attributes of Ketamine and Spravato to help you understand which medication may be more suitable for your needs.

Mechanism of Action

Ketamine is a dissociative anesthetic that works by blocking N-methyl-D-aspartate (NMDA) receptors in the brain. This action leads to an increase in the levels of certain neurotransmitters, such as glutamate and dopamine, which are believed to play a role in mood regulation. On the other hand, Spravato is a nasal spray that contains esketamine, a derivative of ketamine. Esketamine works in a similar way to ketamine by blocking NMDA receptors, but it is thought to have a more targeted effect on certain receptors.

Administration

Ketamine is typically administered intravenously in a clinical setting, where patients are closely monitored by healthcare professionals. The dosage and frequency of ketamine infusions can vary depending on the individual's response to treatment. In contrast, Spravato is a nasal spray that can be self-administered by patients under the supervision of a healthcare provider. The recommended dosing schedule for Spravato involves twice-weekly treatments for the first four weeks, followed by weekly or biweekly treatments thereafter.

Effectiveness

Both Ketamine and Spravato have been shown to be effective in treating treatment-resistant depression in clinical trials. Ketamine is known for its rapid antidepressant effects, with some patients experiencing improvement in symptoms within hours of receiving a ketamine infusion. Spravato has also demonstrated rapid onset of action, with some patients reporting improvement in mood within a few days of starting treatment. However, the long-term effectiveness of both medications is still being studied.

Side Effects

Common side effects of Ketamine include dissociation, dizziness, nausea, and changes in blood pressure and heart rate. These side effects are usually mild and short-lived, but some patients may experience more severe reactions. Spravato also has a similar side effect profile, with common side effects including dissociation, dizziness, sedation, and headache. In addition, Spravato has a boxed warning for sedation and dissociation, which can be serious and may require hospitalization.

Cost

One of the key differences between Ketamine and Spravato is the cost of treatment. Ketamine infusions can be expensive, especially if they are not covered by insurance. The cost of Spravato treatment can also be high, as the medication itself is expensive and requires regular visits to a healthcare provider for administration. Some insurance plans may cover Spravato, but coverage can vary depending on the provider.

Conclusion

In conclusion, Ketamine and Spravato are both effective treatments for depression, particularly treatment-resistant depression. While Ketamine is typically administered intravenously in a clinical setting, Spravato is a nasal spray that can be self-administered by patients. Both medications have rapid onset of action and similar side effect profiles, but Spravato has a boxed warning for sedation and dissociation. The cost of treatment is another factor to consider when choosing between Ketamine and Spravato. Ultimately, the decision of which medication to use should be made in consultation with a healthcare provider based on individual needs and preferences.