Which ketamine-based options do we offer?
“Ketamine treatment” can mean different things, so it helps to know the difference. Spravato (esketamine) is an FDA-approved nasal spray for treatment-resistant depression, given in a certified clinic. IV ketamine infusions use a low dose of ketamine and are an off-label option for depression. Both are given under medical supervision, and neither replaces the rest of your care.
How the two options compare:
- Spravato: FDA-approved nasal spray
- Spravato: self-dosed under observation
- Spravato: 2 hours of monitoring
- IV ketamine: off-label for depression
- IV ketamine: given by a clinician
- IV ketamine: monitored throughout
How is candidacy assessed?
Finding the right fit
Before any ketamine-based treatment, you meet with one of our psychiatrists for a thorough evaluation. Together, we look carefully at:
Ketamine-based treatments are generally considered for adults whose depression hasn’t improved enough after other treatments, such as two or more antidepressants. They may not be suitable if you have uncontrolled high blood pressure, certain heart or vascular conditions, a history of psychosis or an active substance use problem. If neither option fits, we’ll talk through alternatives such as TMS, a medication change or more focused therapy.
Choosing between the options
The right choice depends on your history, preferences and practical needs. Your psychiatrist will explain how Spravato and IV ketamine differ in approval status, scheduling and monitoring, and help you weigh each against your goals. Some things we discuss:
Approval Status
Spravato is FDA-approved for specific uses; IV ketamine for depression is off-label, which we explain in plain terms.
Visit Schedule
Both usually begin with frequent visits for several weeks, then space out based on how you respond.
Side Effects
Dissociation, dizziness, nausea and a short-term rise in blood pressure are possible with either option.
Your Broader Plan
Ketamine-based care sits alongside therapy and psychiatric follow-up, never as a stand-alone fix.
Is ketamine care worth exploring?
Things worth raising at your consult
- Several antidepressants tried
- Depression that hasn’t lifted after months of treatment
- Hard-to-tolerate side effects
- Long-standing low mood
- Relapse after past improvement
- Wanting to review all options
- Medical or heart conditions
- Current substance use
In their own words
Experiences shared by our clients
Theo – project manager
Isla – ceramic artist
Rosa – teacher
Lucas – software engineer
Ivy – illustrator
Nora – writer
Owen – entrepreneur
Frequently
Asked Questions
Questions about ketamine care
Q1: Is Spravato the same as ketamine?
They’re closely related. Spravato contains esketamine, one form of the ketamine molecule, and is FDA-approved; standard ketamine given by IV is used off-label.
Q2: Which option is right for me?
That’s what your evaluation is for. Your psychiatrist will consider your history, health and preferences, and recommend the option—if any—that fits best.
Q3: How quickly might I notice a change?
Some people notice changes within days, while others take longer or don’t respond. We track your progress closely and adjust the plan as needed.
Q4: Will I need to stop my medications?
Usually not, but some medications can interact. Bring a complete list to your evaluation, and your psychiatrist will advise on any changes.
Q5: Do I still need therapy?
We strongly recommend it. Therapy helps you make the most of any improvement and build skills that support longer-term recovery.
