August 11, 2026
If you've been researching new treatments for depression, you've probably encountered two terms frequently: ketamine therapy and Spravato®.
Although these treatments are related, they aren't exactly the same.
Ketamine has been used in medicine for decades and may be administered off-label for depression. Spravato® contains esketamine and is an FDA-approved nasal spray used for specific depressive disorders.
Understanding the differences between Spravato® and ketamine can help you have a more informed conversation with your psychiatrist about which treatment options may be appropriate for you.
At Saltmeadow Psychiatry in Savannah, GA, Dr. Daniel Perry, MD, MPH provides Spravato® treatment for eligible adults as part of personalized, evidence-based psychiatric care.
Ketamine is a medication that has been used in medicine for decades, primarily as an anesthetic. In more recent years, clinicians and researchers have also explored its effects on depressive symptoms.
When ketamine is used to treat depression, it is commonly administered intravenously in a clinical setting. The use of IV ketamine specifically for depression is considered off-label, meaning ketamine is not FDA-approved for depression in this form.
Ketamine works differently from many traditional antidepressants. Rather than primarily affecting neurotransmitter systems such as serotonin or norepinephrine, ketamine's antidepressant effects involve the brain's glutamate system.
This different mechanism is one reason ketamine-related treatments have become an important area of interest for people whose depression hasn't adequately responded to conventional treatments.
Spravato® is the brand name for esketamine, a medication related to ketamine.
Rather than being administered through an IV, Spravato® is delivered as a prescription nasal spray. Patients self-administer the medication under the supervision of a healthcare professional in an approved healthcare setting.
Spravato® has FDA-approved indications for certain depressive disorders, including treatment-resistant depression in adults.
Because potential effects can include sedation, dissociation, and increases in blood pressure, patients are monitored following administration according to established safety requirements.
At Saltmeadow Psychiatry, Spravato® treatment takes place in our Savannah office under appropriate medical supervision.
No. Spravato® and ketamine are closely related, but they aren't identical medications.
Ketamine contains two molecular forms, known as enantiomers. Esketamine is the S-enantiomer of ketamine.
This distinction matters because Spravato® has been specifically formulated, studied, and FDA-approved for certain depressive disorders.
You may sometimes hear Spravato® described informally as "nasal ketamine." While this helps explain the relationship between the treatments, esketamine is the more accurate description.
Although both treatments are related, there are several important differences patients should understand.
Spravato® has FDA-approved indications for certain depressive disorders.
Ketamine itself is an FDA-approved medication for other medical purposes, but IV ketamine treatment specifically for depression is considered off-label.
Spravato® is administered as a nasal spray under medical supervision.
IV ketamine is delivered directly into the bloodstream through an intravenous infusion.
Spravato® must be administered in an appropriate healthcare setting with post-treatment observation and monitoring.
IV ketamine for depression is generally provided through clinics or infusion centers, with protocols varying by provider.
Insurance coverage can also differ between the two treatments.
Because Spravato® has FDA-approved psychiatric indications, many insurance plans may provide coverage for eligible patients when medical-necessity and prior-authorization requirements are met.
IV ketamine treatment for depression is frequently self-pay, although coverage and costs vary.
Saltmeadow Psychiatry can help patients navigate insurance verification and prior authorization when pursuing Spravato® treatment.
Ketamine and esketamine interact with the brain's glutamate system, distinguishing them from many conventional antidepressants.
Glutamate is an important neurotransmitter involved in communication between brain cells and neural plasticity.
The biological mechanisms involved are complex and continue to be studied. For patients, one of the important differences is that ketamine-related treatments work through pathways that differ from many traditional antidepressant medications.
This makes Spravato® a treatment worth evaluating for certain individuals whose depression has not adequately responded to previous treatments.
Spravato® isn't appropriate for everyone.
Eligibility depends on several factors, including your diagnosis, previous treatments, current medications, medical history, and overall health.
For patients experiencing treatment-resistant depression, a psychiatrist may review:
A comprehensive psychiatric evaluation is necessary to determine whether Spravato® may be an appropriate treatment option for you.
Treatment begins with a psychiatric evaluation to determine whether you meet the appropriate clinical criteria.
If Spravato® is recommended, treatments are scheduled at the medical office.
During an appointment, the medication is self-administered as a nasal spray under supervision. Patients remain in the office afterward for monitoring because temporary effects can occur following treatment.
Your healthcare team will also explain important treatment-day requirements, including transportation and activity restrictions after your appointment.
Spravato® isn't generally a one-time treatment. It follows a structured treatment schedule, with treatment frequency changing over time according to the prescribed plan and individual response.
Like any prescription medication, Spravato® can cause side effects.
Potential effects may include:
These potential effects are one reason Spravato® is administered in an appropriate healthcare setting rather than taken independently at home.
Before treatment begins, your psychiatrist will discuss potential benefits, risks, contraindications, and treatment requirements with you.
There isn't one treatment that's automatically better for every patient.
The appropriate treatment depends on your diagnosis, previous treatments, medical history, clinical needs, accessibility, insurance coverage, and other individual considerations.
Spravato® provides an FDA-approved treatment pathway for certain depressive disorders along with standardized requirements for administration and monitoring.
IV ketamine has also been used clinically for depression, but this psychiatric use is off-label.
Rather than selecting a treatment based solely on online comparisons, patients should discuss their history and available options with a qualified psychiatric provider.
Not experiencing adequate improvement with previous antidepressants doesn't necessarily mean you've run out of treatment options.
Persistent depression despite appropriate treatment may indicate treatment-resistant depression.
A psychiatrist can reassess your symptoms, diagnosis, previous medications, treatment response, and any co-occurring conditions that could be influencing your depression.
Depending on your individual circumstances, the next step could involve medication adjustments, psychotherapy, combination treatment, or an advanced treatment option such as Spravato®.
The goal is to find an evidence-based treatment approach appropriate for your individual needs rather than repeatedly trying treatments without a broader reassessment.
Saltmeadow Psychiatry provides Spravato® therapy in Savannah, GA, for eligible adults seeking treatment for depression that hasn't adequately responded to traditional approaches.
Dr. Daniel Perry, MD, MPH provides comprehensive psychiatric evaluations and integrates Spravato® into an individualized treatment plan when clinically appropriate.
Our Savannah practice serves patients from Pooler, Richmond Hill, Wilmington Island, Effingham County, and surrounding Georgia communities.
If you're researching ketamine therapy in Savannah, GA and want to understand whether Spravato® may be an appropriate option for you, contact Saltmeadow Psychiatry to schedule a consultation.
Saltmeadow Psychiatry
315 Commercial Drive, Suite D-6
Savannah, GA 31406
Phone: (912) 513-2888
Book an Appointment
Spravato® contains esketamine, which is closely related to ketamine. Although people sometimes refer to it as nasal ketamine, Spravato® is specifically an esketamine nasal spray with FDA-approved psychiatric indications.
Spravato® has FDA-approved indications involving certain depressive disorders. Whether it is appropriate for an individual patient requires evaluation by a qualified healthcare professional.
Ketamine is an FDA-approved medication for other medical purposes, but the use of IV ketamine specifically for depression is considered off-label.
No. Spravato® is administered in an appropriate healthcare setting under supervision, followed by required monitoring.
Many insurance plans may provide coverage for eligible patients. Coverage, prior-authorization requirements, deductibles, and copays vary by plan, so individual benefits should be verified before treatment.
A psychiatric evaluation is the first step. Your provider will review your symptoms, diagnosis, medical history, previous depression treatments, current medications, and other relevant factors before determining whether Spravato® may be appropriate.
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