*The FDA has not approved intravenous ketamine or NAD+ for the treatment of any psychiatric or pain condition. These articles reference off-label use. Like all medical treatments, the discussed therapies carry risks and benefits. Speak with a doctor at Clarus Health to learn if these therapies may be right for you.
Ketamine Spray vs Infusion: the Science in Clear
Learn how IV Ketamine is the fastest acting, most effective, and safest form of ketamine therapy
Ketamine treatment is confusing because ketamine can come in so many forms. The latest round of scientific investigations continues to show that IV Ketamine remains the fastest-acting and most effective form of ketamine for treatment-resistant depression.
Why Does Ketamine Comes in so Many Forms?
Ketamine is very safe when administered by a trained doctor. Depending on your condition and the expertise of your doctor, you may receive oral, intranasal, intramuscular, or intravenous forms of ketamine. In general, the more effective the form, the more specialized your doctor needs to be. You should always ask your doctor questions about their expertise with different forms of ketamine.
In general, the more effective the form of Ketamine, the more specialized your doctor needs to be
Is Ketamine Spray Effective?
The FDA has approved esketamine (Spravato), a form of the 50 year old ketamine, for treatment-resistant depression. It's effectiveness is impressive, helping over 40% of patients who have long struggled with depression.
Unfortunately, because Spravato comes in a spray form, it has serious limitations:
- Lower absorption of medication (50% bioavailability)
- Consistency of absorbed dose
- Limited dose customization
- Inability to combine adjunctive medications
These limitations impact the overall effectiveness of intranasal ketamine compared to IV Ketamine therapy.
IV Ketamine is Faster and More Effective than Intranasal Ketamine
Despite many misconceptions, IV Ketamine appears superior to intranasal ketamine based on numerous studies. The complete absorption provided by the IV route affords multiple benefits to IV Ketamine over intranasal forms:
- Faster symptom relief
- A recent study demonstrated IV Ketamine acting 2x as fast as intranasal
- More effective treatment course, especially early in treatment
- Fewer treatments are needed with IV than with intranasal
- Response rates of ~40% (intranasal after 24 hours & 28 days) vs up to 79% with IV Ketamine
- Ability to add adjuncts to the infusion (vitamins and minerals)
- Rapid dose adjustments to maximize safety and comfort
- Combination with the Stellate Ganglion Block to augment symptom relief from PTSD
- Direct doctor supervision ensures safety
Both intranasal and IV Ketamine work faster than oral ketamine, which may take weeks to show benefit.
Which form is "best?" For patients seeking the fastest and safest form of ketamine therapy, IV Ketamine is the clear choice.
Ketamine Spray vs Infusions: Which is Right For You?
Deciding between different forms of ketamine should be done with a doctor who fully understands the differences between oral, nasal, muscular, and IV forms. There is no one right answer, but for patients seeking the fastest and safest form of ketamine therapy, IV Ketamine is the clear choice. You should always speak with your doctors to learn about the risks and benefits of ketamine therapy so you can make an informed decision. Learn more about the right treatment for you by contacting Clarus Health today.
Anthony Kaveh MD
Dr. Kaveh is a Stanford and Harvard-trained anesthesiologist and integrative medicine specialist. He has over 800,000 followers on social media and has guided hundreds of patients throughout transformative healing experiences. He is an authority on Ketamine, NAD, and SGB therapies. He is a registered continuing education lecturer in the Bay Area.
