For people who have been struggling with treatment resistant mental illnesses like depression, ketamine therapy has become a mainstream and viable option. In 2019 the FDA approved a nasal spray using a form of ketamine known as esketamine and branded as Spravato. The nasal spray has been presented as an alternative to IV ketamine therapy, which is an approved anesthetic and is used to treat major depression and other mental disorders. For those who are seeking help from Maryland psychiatry professionals, the difference between the two forms of ketamine therapy can be confusing. Let’s explore all of the ways that the two types of treatment differ so you and your psychiatrist can decide which method is right for your mental health needs.
Differences in Ketamine Treatment Processes
When you pursue ketamine therapy through the Maryland psychiatry system, it is important to know what your treatment will look like
Let’s begin with one of the most important questions regarding the two types of ketamine therapy — what will my treatment look like? If you and your psychiatrist decide that ketamine is the right treatment path for you can expect the following treatment processes.
When you are receiving IV ketamine, you are connected to an IV drop of about 1/10 the amount of ketamine that is used as an anesthetic. The treatment will usually last about 40 minutes to an hour and your Maryland psychiatry center will make sure you are comfortable for the duration of your treatment.
Should you opt for the esketamine nasal spray, also known as Spravato, you can expect a less invasive delivery method. Spravato is sprayed up the nose and only takes a few minutes to administer. As of right now, the FDA requires patients to wait for 2 hours after their esketamine treatment for observation.
Efficacy and Therapeutic Effects
Let’s find out how effective IV therapy is compared to esketamine nasal spray for treating mental illnesses
Now that we have explored the differences in treatment, let's get into what results you can expect from both forms of ketamine therapy.
For IV ketamine treatments, they have proven to be more effective in treating major depression because the ketamine in the IV is more bioavailable and the drug is easily absorbed through the bloodstream. It has more immediate effects and may lead to a shorter overall treatment time depending on your symptoms.
For the esketamine nasal spray, the ketamine has to pass through the tissues of the nose and sinuses to reach the brain and take effect. Because it has to be absorbed nasally, it can be less effective and take patients a longer time to feel the therapeutic effects of the drug. However, studies show that esketamine can be very effective if paired with the right oral antidepressants.
Possible Side Effects
Both IV therapy and esketamine have some mild side effects that should not persist after treatment
In both forms of treatment, the side effects are relatively the same. For treatments, the most common side effects are sedation and dissociation. Since ketamine is approved by the FDA as an anesthetic, feelings of sedation are to be expected. Though these symptoms are usually mild, when using esketamine spray you are required to be under supervision for 2 hours after the drug has been administered. It is extra important to refrain from using any other substances that could depress the central nervous system.
Dissociation is another common side effect of both types of ketamine therapy. Ketamine is sometimes recognized as a street drug known for causing hallucinations. Though the medical dose is not nearly as high as when the drug is used illegally, it still could produce some feelings of dissociation in patients. After receiving ketamine treatment, it is common to feel disconnected from yourself or your surroundings, but symptoms will subside within a few hours.
Estimated Total Cost of Treatment
Generally, esketamine treatment tends to be more expensive than IV treatment
If you are considering ketamine therapy to treat major depression, you might be curious about the cost difference between the two delivery methods. In general, esketamine nasal spray is much more expensive than IV ketamine treatments. According to a research study by McLean Hospital, “The authors estimated a greater than 95% likelihood that intranasal esketamine would not be cost-effective in the United States, according to commonly applied standards. Also, they concluded that the price of esketamine must fall by more than 40% from its current price of approximately $240 per dose to be cost-effective.” Because esketamine nasal spray is yet to be affordable for those who need it most, IV ketamine treatment is the more affordable option for many patients.
Health Insurance Coverage
Where esketamine is covered under some health insurances, IV ketamine therapy is not
While ketamine IV treatment is not covered by insurance, esketamine nasal spray is covered by some insurances. Depending on your insurance and symptoms, esketamine could be the right option for you. All ketamine IV treatments are paid for out of pocket, though even without insurance IV treatments can sometimes still be less expensive overall than the nasal spray.
If you still have questions about the different ketamine treatment options, talk to your psychiatrist about which option will work best for you mentally and financially. Thanks to developments in Maryland psychiatry, there are many clinics where ketamine treatment is administered. If you are considering either form of Ketamine therapy, you can always contact the Bloom Health Centers to speak to one of our licensed professionals.