The comparison between Spravato (esketamine) and ketamine infusion for treatment-resistant depression is complex, and the choice between the two depends on various factors, including individual patient characteristics, preferences, and treatment history. Here are some key points to consider when evaluating these treatment options:
Administration method: Spravato is a nasal spray formulation of esketamine, which is a specific enantiomer of ketamine. Ketamine infusion involves the intravenous (IV) administration of ketamine. The administration method can influence factors such as convenience, frequency of treatment, and potential side effects.
FDA approval: Spravato received FDA approval for the treatment of treatment-resistant depression, whereas ketamine infusion is often considered an off-label use for depression. Being an FDA-approved medication may influence insurance coverage and accessibility for some patients.
Treatment setting: Ketamine infusion is typically administered in a clinical setting, while Spravato can be prescribed for at-home use under the supervision of a healthcare provider after the initial doses are administered in a clinical setting. This can impact the level of monitoring required during treatment.
Efficacy: Both Spravato and ketamine infusion have shown promising results in providing rapid relief for some individuals with treatment-resistant depression. However, individual responses can vary, and not everyone will experience the same level of improvement.
Side effects: Both treatments can cause side effects, which may differ in nature and severity. Common side effects of ketamine and esketamine include dissociation, dizziness, nausea, and potential abuse or dependence concerns with long-term use.
Cost: Cost considerations may vary depending on factors such as insurance coverage, the frequency of treatment, and the setting where treatment is administered.
Given these complexities, it's crucial for individuals with treatment-resistant depression to consult with a qualified mental health professional, such as a psychiatrist or a specialist in mood disorders. They can conduct a thorough evaluation of the patient's medical history, symptoms, and treatment response to determine the most appropriate treatment plan.
Ultimately, the choice between Spravato and ketamine infusion should be made in consultation with a healthcare provider, weighing the potential benefits, risks, and individual circumstances of the patient. Additionally, ongoing research may further refine our understanding of the comparative effectiveness of these treatments for treatment-resistant depression.