Spravato vs Ketamine Infusions. What’s the Difference
If you’ve been exploring treatment options for depression that hasn’t responded to medication, you may have come across two advanced alternatives. Spravato esketamine and IV ketamine infusions. Both are ketamine based treatments and both can work faster than traditional antidepressants. But they are not the same.
At Perfect Balance Psychiatric Services in Frisco TX, we help patients understand both options with clarity and care. This guide breaks down how each treatment works, what makes them different, and what to consider when choosing your path.
Quick Summary. Spravato vs Ketamine Infusions
Feature | Spravato Esketamine Nasal Spray | IV Ketamine Infusions |
Form | Nasal spray | Intravenous IV infusion |
FDA Approved | Yes | No off label |
Active Ingredient | Esketamine | Racemic ketamine |
Administration Location | Certified REMS clinic | Ketamine clinic varies |
Insurance Coverage | Often covered | Rarely covered |
Monitoring Required | 2 hours | 1 to 2 hours |
Ideal For | TRD, MDD with suicidal thoughts | TRD, PTSD, chronic pain |
What Is Ketamine
Ketamine is a dissociative anesthetic developed in the 1960s. It is known for rapid effects on mood and suicidal thinking. Unlike antidepressants that target serotonin, ketamine targets glutamate which supports neuroplasticity and emotional recovery. This allows for fast symptom relief, sometimes within hours.
What Is Spravato
Spravato is a more potent, refined version of ketamine called esketamine. It is the only FDA approved ketamine based treatment for depression.
Approved for
- Treatment resistant depression
- Major depressive disorder with suicidal thoughts
How Spravato Works
- Administered in office
- You self-administer the nasal spray
- You are monitored for two hours
- Treatments are twice weekly for four weeks then taper
Spravato is provided only at REMS certified clinics like Perfect Balance Psychiatric Services.
What Are Ketamine Infusions
IV ketamine infusions deliver the full ketamine molecule through an IV line over 40 to 60 minutes. They are used off label for:
- Depression
- Anxiety
- PTSD
- Chronic pain
- OCD
What to Know About IV Ketamine
- Provided at specialty clinics
- Often not supervised by psychiatrists
- Typically not covered by insurance
- Requires multiple weekly sessions
- Safety protocols vary widely
Which Is Safer
Spravato offers predictable safety because:
- FDA approved
- Strict national REMS protocol
- Psychiatric oversight required
- Consistent monitoring standards
IV ketamine clinics may vary in structure, oversight, and safety controls.
What About Insurance Coverage
Spravato
Often covered by:
- Blue Cross Blue Shield
- Aetna
- UnitedHealthcare
- Cigna
- Medicare Advantage plans
IV Ketamine
Rarely covered
Typical cost. $400+ to $800+ per infusion
At Perfect Balance, we handle all pre authorization steps for Spravato to reduce financial stress.
How Fast Do Spravato and Ketamine Work
Both treatments act faster than traditional antidepressants, but their timelines differ.
Spravato Timeline
- Improvement often begins within 2 to 4 weeks
- Steady progress during the first 8 treatments
- Peak results after completing the induction phase
IV Ketamine Timeline
- Some patients feel relief within hours
- Many require six infusions over 2 to 3 weeks
- Maintenance infusions may be needed monthly
If you prefer a structured and gradual improvement, Spravato is ideal. If fast onset is your priority, ketamine infusion may appeal more though it is off label and self paid.
Which Option Is Right for You
| Choose Spravato if | Choose IV Ketamine if |
| You want an FDA approved treatment | You are open to off label options |
| You need insurance coverage | You are able to pay out of pocket |
| You prefer a structured, monitored program | You are exploring treatment for conditions like PTSD or chronic pain |
| You are being treated for depression with suicidal thoughts | You already tried Spravato or want alternative formats |
At Perfect Balance Psychiatric Services in Frisco TX, we provide Spravato in a safe, private, supportive environment. If we believe ketamine infusions are a better fit, we guide you to reputable options.
Your path becomes clearer immediately.
Schedule Your Spravato Consultation in Frisco TX
If you’ve been struggling with depression that has not improved with medication or therapy, Spravato may be the breakthrough you need.
We make the process easy by:
- Handling insurance approvals
- Providing a calm, comfortable treatment room
- Offering expert psychiatric supervision and monitoring
📞 Call us: 972 781 0100
🌐 Visit: www.pbpsychiatricservices.com
📍 Serving: Frisco TX and surrounding areas with evidence based mental health care
The right mental health care starts with the right guide. Let’s find your perfect balance.
