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Spravato vs. Ketamine

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Spravato

(esketamine)

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Ketamine

(Ketalar)

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Summary for Spravato

Prescription only

Spravato (esketamine) is used for adults with treatment-resistant depression (TRD). It also treats adults who have depression with suicidal thoughts or behavior. As an NMDA antagonist, it works in the brain to regulate mood. Spravato (esketamine) is a nasal spray that you must use at a treatment center. At first, you take it twice a week for 4 weeks. After that, people with treatment-resistant depression can take it once a week. Side effects include feeling sleepy and dissociated (disconnected from your thoughts or feelings). Side effects can be serious, so you must join the Spravato REMS program to get treatment.

Indications for Spravato

Pros and Cons for Spravato

Pros

  • Generally only need to take 1 or 2 times each week
  • Available through a REMS program that helps makes sure the medication is used safely
  • Can be used by itself for people with treatment-resistant depression who've already tried 2 oral antidepressants

Cons

  • Can't give the medication to yourself at home (must go to a treatment center to take)
  • Requires 2 to 3 sprays in each nostril for each dose
  • Serious risks of sleepiness; slowed breathing; and feeling disconnected with your thoughts, feelings, and sense of self

Common Side Effects for Spravato

  • Dissociation (disconnected from your thoughts, feelings, or sense of self, 41%)
  • Dizziness (29%)
  • Nausea (28%)
  • Sleepiness (23%)
  • Vertigo (feeling like the room is spinning, 23%)
  • Headache (20%)
  • Changes in taste (19%)
  • Numbness (18%)
  • Anxiety (13%)
  • Feeling sluggish (11%)
  • Higher blood pressure (10%)

Warnings for Spravato

  • Sleepiness, slowed breathing, and dissociation
  • Potential for misuse and dependence
  • Must enroll in the Spravato REMS program to get treated
  • Suicidal thoughts and behaviors in young adults
  • Higher blood pressure
  • Problems with your mental abilities (e.g., thinking, concentrating, remembering)
  • Bladder problems
  • Harm to an unborn baby

Summary for Ketamine

Prescription only

Ketamine (Ketalar) is a medication that's injected into the muscle or infused into the vein before a surgery or procedure to help you sleep so you don't feel pain. This is called general anesthesia. Ketamine (Ketalar) can only be given by a trained healthcare provider who can monitor your breathing and vital signs during your treatment.

Indications for Ketamine

  • General anesthesia before a surgery or procedure

Pros and Cons for Ketamine

Pros

Cons

Warnings for Ketamine

  • Unstable vital signs
  • Reactions after waking
  • Breathing problems
  • Risk in newborns and children
  • Liver problems
  • Interactions with other medications

Prices with our coupons for Spravato vs. Ketamine

Price Card Drug Icon
Spravato1 nasal spray / three 28mg nasal sprays of 84mg
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Ketamine3 vials / 5ml of 100mg/ml
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