Ketamine is used in psychiatry for treatment-resistant depression. It can be given by an IV or with a nasal spray.
Both types are FDA approved, but one might be better than the other when it comes to access and affordability. Find out how ketamine works, when to consider treatment, and which type might be best for you.
What is Ketamine?
Ketamine isn’t new. It’s a medication that’s been used for decades. Originally, it was used for anesthesia in surgical or emergency operations.
But in much lower doses, it’s been found to rapidly improve symptoms of depression.
Unlike depression medications, ketamine acts on a neurotransmitter called glutamate, which regulates mood, learning, and mental adaptability.
This unique mechanism is one reason ketamine has become popular for those who feel nothing has worked.
In psychiatry, ketamine refers to both traditional intravenous (IV) ketamine and esketamine, the FDA-approved nasal spray known as Spravato.
Both treatments are used under close medical supervision in approved clinics.
When is Ketamine Needed for Treatment?
Ketamine isn’t a first-line treatment. It’s for individuals who feel stuck after years of medication changes with no relief.
It’s often recommended for treatment-resistant depression or when symptoms are severe enough that they impact the function of everyday life.
A thorough clinical evaluation helps determine whether it’s the right fit.
Some patients also ask about ketamine treatment for bipolar depression. In these cases, ketamine may not be the right fit, but it can certainly be considered after a full medical workup is completed and when mood stabilizers are already in place.
It’s always important to speak with a medical professional about treatment options. Book your appointment today with a BNBA psychiatrist to see if ketamine treatment is right for you.
How Is Ketamine Administered?
Ketamine can be administered in many ways, depending on the treatment and clinic setting. These include intravenous (IV) infusions, intramuscular injections, oral forms, and intranasal options.
Spravato is the brand name of the nasal spray esketamine given in the clinic. Treatment begins with frequent visits early on and then gradually spaces out to maintenance sessions.
After each Spravato treatment, patients remain in the clinic for monitoring to ensure safety and comfort. This supervised approach is an important part of how ketamine therapy is delivered responsibly.
What Are the Side Effects?
The most common side effects of the nasal spray include dizziness, sleepiness, nausea, dissociation, and temporary increases in blood pressure.
These effects normally occur during the treatment session and resolve within a few hours.
Some people describe dissociation as feeling detached or as if in a dream, which can be unsettling at first but is usually short-lived. Clinic staff are present the entire time to provide reassurance and support.
Most patients report that side effects lessen over time as their body becomes familiar with treatment. Understanding what to expect often helps reduce anxiety during sessions.
What is the Success Rate?
Patients often ask about the Spravato success rate, especially after years of little or no response to their traditional medications.
Clinical studies and real-world experience show that many people with treatment-resistant depression experience marked improvement.
But success looks different for each person. For some, it means fewer depressive days, improved energy, or a renewed ability to engage in daily life.
While ketamine is not a cure-all, it has opened the door to meaningful relief for patients who felt out of options. When combined with ongoing psychiatric care and therapy, outcomes are even better.
Conclusion
Although the gold standard for the treatment of refractory depression is IV ketamine, not everyone has access to it.
Insurance approvals, transportation issues, the cost of care, not to mention the fear of needles, limit access to the traditional style of ketamine treatment.
Nasal spray ketamine or esketamine (Spravato) is likely a better option when these obstacles arise. It bridges the gap between needing a hospital and failed medications.
Find Out If Ketamine Is Right for You
If you’ve been suffering from depression that feels untreatable, call our office today for an appointment. By speaking with a professional, you’ll learn if ketamine treatment is an option for you.
Author:
Scott Arno
Physician Assistant
Boston Neurobehavioral Associates