Ketamine vs Spravato are two treatment options often explored by people with depression who haven’t found relief from traditional antidepressants. While they’re related, they are not the same, and choosing the right one depends on your symptoms, medical history, insurance coverage, and treatment goals.
At Golden Hour Wellness, we offer both ketamine infusions and Spravato, allowing us to help patients choose the option that’s truly best for them – not just the one we happen to offer.
Below, we break down the key differences in a clear, honest way.
What Do Ketamine and Spravato Have in Common?
Both treatments:
- Act on the glutamate system rather than serotonin
- Can work faster than traditional antidepressants
- Are used for treatment-resistant depression
- Require medical supervision
- Are backed by growing clinical research
That’s where the similarities end.
What Is Ketamine Infusion Therapy?
Ketamine infusion therapy uses racemic ketamine, administered intravenously in a controlled medical setting.
Key Features:
- Delivered via IV infusion
- Dose is customized for each patient
- Typically offered as a series of infusions
- Often produces rapid symptom relief (sometimes within hours to days)
- Not currently covered by insurance, but may qualify for a super bill
Who It’s Often Best For:
- Patients with severe or long-standing depression
- Those needing rapid relief
- Patients who have tried multiple medications without success
- Individuals with co-occurring anxiety, PTSD, or chronic pain
What Is Spravato® (Esketamine)?
Spravato is an FDA-approved nasal spray form of esketamine, derived from ketamine, and used specifically for depression.
Key Features:
- Administered as a nasal spray
- Must be taken in-clinic under REMS program guidelines
- Requires a 2-hour observation period
- Often covered by insurance
- Usually paired with an oral antidepressant
Who It’s Often Best For:
- Patients who need or prefer insurance-covered treatment
- Those looking for a structured, longer-term maintenance option
- Patients who respond well but don’t need IV dosing
Ketamine vs. Spravato: Side-by-Side Comparison
Administration
- Ketamine: IV infusion
- Spravato: Nasal spray
Speed of Relief
- Ketamine: Often very fast (hours–days)
- Spravato: Gradual over multiple sessions
Customization
- Ketamine: Highly customizable dosing
- Spravato: Fixed dosing protocol
Insurance
- Ketamine: Typically self-pay
- Spravato: Often covered by insurance
Best For
- Ketamine: Rapid relief, severe or complex cases
- Spravato: Ongoing care with insurance support
Which One Works Better?
There is no one-size-fits-all answer.
Some patients respond better to ketamine infusions. Others do very well on Spravato. Many patients even start with ketamine infusions for symptom relief and later transition to Spravato for maintenance — or vice versa.
The most important factor is proper screening and medical guidance.
How We Help You Decide at Golden Hour Wellness
We don’t believe in pushing one treatment over another.
At Golden Hour Wellness, you’ll receive:
- A comprehensive medical and psychiatric evaluation
- Guidance from experienced clinicians
- Honest discussion of costs, benefits, and expectations
- Ongoing monitoring for safety and effectiveness
When comparing ketamine vs Spravato, the right choice depends on your symptoms, medical history, and treatment goals. Our goal is simple: help you feel better — safely and sustainably.