By now, you have probably read or have seen news reports about the recent FDA approval of a new nasal spray form of Ketamine called Esketamine, known under the brand name Spravato. Esketamine is celebrated for its potential to treat treatment resistant depression.
The FDA’s approval of Esketamine is the first time a Ketamine-like drug has received FDA approval and further supports the use of Ketamine therapy for conditions that are difficult to treat with traditional medication.
Esketamine garnered further attention in August when President Trump ordered the Department of Veterans Affairs (VA) to include Esketamine in their coffer of drugs to treat veteran depression.
In this article, we will look at the advantages and disadvantages in the use of nasal Esketamine, in comparison to the current and widely accepted treatment using Ketamine Infusion Therapy.
The Difference Between Esketamine Nasal Spray and Ketamine
Ketamine was originally used as an animal sedative and as an anesthetic. Because of the “high” it can produce, it’s also been misused as a party drug. Research out of Yale has found that it can reduce depression and suicidality. Other studies have shown that it effectively “rewires” the synapsis of the brain – essentially rewiring depression out of the brain. It’s often administered medically in a liquid form through infusions.
Esketamine is related to the drug ketamine. Johnson & Johnson developed the ketamine derivative and sell it as a nasal spray called Spravato. This new drug does not yet have a generic formulation, and will not have one for many years due to a patented formulation owned by the drug company. Spravato received FDA approval in March.
Esketamine vs Ketamine Infusions: Which is More Effective?
Ketamine infusions have been shown to be up to 80% effective in the treatment of severe depression. This is in contrast to the studies of Esketamine nasal spray, which only show up to 40% effectiveness.
Johnson & Johnson (who developed Spravato) sponsored a study earlier this year, which found those who received Esketamine treatment in combination with standard treatment demonstrated fewer depression symptoms, but not suicidality.
And while Esketamine has FDA approval and Ketamine infusions don’t, the same study only showed minimal improvement in depressive symptoms with Esketamine treatment(at the current recommended dosage) compared to placebo.
Earlier this year, we shared the story of a man named Thomas who found relief from severe depression and PTSD through Ketamine infusions. And he’s not alone: 70% of patients who receive Ketamine infusions report feeling happy. And many find this relief after their first ketamine infusion.
Esketamine vs Ketamine Infusions: Cost and Frequency of Treatment
Because neither Esketamine nor Ketamine infusions are covered by insurance (yet), cost and frequency of treatment is an important consideration.
For both Esketamine and Ketamine infusions, frequency of treatments is similar for the first 2 weeks – know as the induction phase of treatment. Maintenance treatments, however, differ significantly. Treatment with Esketamine nasal spray is performed once every week or once every 2 weeks. Maintenance treatment with Ketamine infusions is every 4 to 6 weeks.
Esketamine is expected to cost between $590 and $885 (wholesale price) per dose. For the treatment regimen, it will range from $4,720-$6,785 (wholesale cost) for total of 8 weeks of therapy. Retail cost to consumer is not yet known, but is expected to be over $1,000 per dose or more than $8,000 for 8 weeks of therapy.
In contrast, the cost of Ketamine Infusion Therapy ranges from $600-$800 per dose at retail. 8 weeks infusions costs between $3,500 and $4,900 retail (assuming average response to therapy).
Esketamine vs. Ketamine Infusions: Length of Treatment Sessions
If you’re considering Esketamine or Ketamine infusions to treat depression, you should also weigh the amount of time needed for either treatment. Esketamine requires 2 hours of monitoring after administration, and with a high administration rate.
Ketamine infusions use only take about 70 minutes from the time the infusions start till you are discharged. And they don’t have to be administered as frequently as Esketamine.
Is Ketamine right for you?
Scheduling a free consultation is the best way to know if Ketamine Infusion Therapy is the right treatment for you or your loved one. Virginia Infusion Therapies, located in Loudoun County, is Virginia’s leading provider of Ketamine Infusions for depression and pain conditions.