Explore Supervised Advanced Treatment Options
IM ketamine and Spravato® (esketamine) are different treatments that require clinical screening, informed discussion, and appropriate monitoring. Ketamine is FDA-approved as an anesthetic and is not FDA-approved to treat psychiatric disorders, while Spravato is an FDA-approved esketamine nasal spray for specific adult indications, including treatment-resistant depression, with an oral antidepressant.
Before treatment, a clinician reviews the person’s symptoms, medical history, medications, and relevant safety considerations to determine whether the treatment may be appropriate. Spravato must be administered under healthcare supervision through the required REMS program, with patients monitored for at least two hours after administration because of risks including sedation and dissociation.
What Patients Should Know About These Options
Careful screening and monitoring are central to using these treatments responsibly.
- A clinical assessment helps determine whether a person is an appropriate candidate for a particular treatment.
- The clinician can explain expected effects, potential risks, alternatives, and the monitoring process before treatment begins.
- Spravato treatment requires administration in a qualified healthcare setting under the federal REMS requirements.
- Ketamine used for psychiatric purposes is different from FDA-approved Spravato and should be discussed with a qualified clinician in the context of the individual’s care.
When To Ask About Ketamine-Based Treatment
A person may want to discuss these treatment options when:
- Standard depression treatments have not provided adequate improvement
- A clinician has identified a condition for which a specialized treatment may be considered
- They want to understand alternatives after previous treatment experiences
- They have questions about Spravato or ketamine and whether either is appropriate
- They are prepared to discuss medical history, medications, risks, and treatment expectations with a clinician
FAQs
What is the difference between IM ketamine and Spravato?
IM ketamine involves ketamine administered by injection, while Spravato is esketamine delivered as a nasal spray. Ketamine is FDA-approved as an anesthetic rather than for psychiatric disorders, whereas Spravato has specific FDA-approved psychiatric indications and is subject to a restricted REMS program.
Who may be considered for Spravato treatment?
FDA-approved Spravato is indicated for adults with treatment-resistant depression and for depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior, in conjunction with an oral antidepressant. A clinician must determine whether it is appropriate for the individual after reviewing their clinical history and safety considerations.
What happens during a Spravato treatment visit?
Spravato is administered under healthcare supervision, followed by monitoring for potential effects such as sedation and dissociation. The FDA labeling requires at least two hours of monitoring after administration and an assessment before the patient leaves the healthcare setting.
Is ketamine FDA-approved for depression?
Ketamine itself is FDA-approved as an anesthetic, not as a treatment for psychiatric disorders. Its use for psychiatric conditions is therefore different from an FDA-approved psychiatric indication and should be discussed carefully with a qualified clinician.
What should someone expect before starting treatment?
The clinician reviews the person’s symptoms, medical history, medications, and potential risks before determining whether treatment is appropriate. The discussion should also cover alternatives, monitoring, expected effects, and what follow-up may involve.
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