Ketamine is quickly building a reputation for itself. Medical research increasingly points to its ability to turn around treatment resistant depression when traditional depression treatments have failed. And as research continues into this “wonder drug,” it seems like its potential uses could be endless. Research has linked it to treating alcoholism, bipolar disorder, autism, tourettes, schizophrenia, chronic regional pain syndrome, and more.
And a derivative of Ketamine called esketamine has been approved by the FDA for treating depression. It’s a nasal spray that’s sold as a drug called Spravato – which has launched debate about ketamine infusions vs nasal spray. But at Virginia Infusion Therapies, we stand by administering ketamine infusion treatments. And here’s why we recommend ketamine infusions:

Why Ketamine Infusions Matter
Ketamine infusions matter because the way our bodies receive and interact with medicine impacts the medicine’s effectiveness. And it all goes back to “bioavailability” – or, the amount of a substance that the body actually ends up using versus the amount you put into your body.
When medications are received in pill form, only about 16-24% of that medication gets used by your body. When medication is received through your nose – as in the case of Spravato – only 25% to 50% of the medication gets used by your body.
The amount of barriers the medication has to pass through causes the low bioavailability rates. Pills have to pass through your digestive tract – including harsh stomach acid – before entering your bloodstream then heading to your brain. Nasal sprays have to pass through several layers of tissue before reaching your brain, let alone the medication potentially lost through sneezing or mucous drainage.
And although nasal sprays have a better bioavailability score than pills, they still don’t compare to infusions, which have a 100% bioavailability rate because they enter your bloodstream directly and then head straight to your brain.
Other Ketamine Infusion Treatment Benefits
Ketamine infusions add predictability to your ketamine treatment: your practitioner will know exactly how much ketamine your body is absorbing. As a result, they will be better able to tailor your treatment to your needs.
Ketamine infusions also enable close monitoring during treatment. If you begin to experience undesirable side effects, your practitioner can stop or adjust the treatment.
Ketamine infusions also require less frequency in treatment, meaning lower overall cost to the patient because as of now insurance covers neither intravenous ketamine nor nasal spray esketamine.
Ketamine infusions also require less overall treatment time than the nasal spray. Not only are the treatments less frequent, but each ketamine infusion treatment takes less time. A ketamine infusion for depression usually only requires about 70 minutes. A single esketamine nasal spray treatment requires 2 hours of patient monitoring after each treatment.

Ketamine Infusion vs. Nasal Spray Esketamine: Ketamine's Proven Track Record
Research has proven that ketamine infusions are 70% effective in treating treatment resistant depression AND suicidality. And that effective rate has been proven over nearly a decade of real world clinical use.
In contrast, esketamine nasal sprays don’t have an established a track record even close to ketamine infusions since Spravato (esketamine nasal spray) only received FDA approval less than a year ago.
Ketamine Infusion vs Nasal Spray - which will you choose?
If you are suffering from a condition like treatment resistant depression and are wondering whether ketamine infusions or esketamine nasal spray will work best for you, we suggest simply scheduling a free 15 minute consultation with one of our doctors.
They’ll be able to answer any questions and concerns you might have about ketamine infusions. And their expertise can help guide you to a decision that’s best for you.