Ketamine infusion therapy has taken the medical world by storm in recent years, and with good reason. This unique medication has proven to be highly effective in treating a variety of mental and physical health conditions, including depression, anxiety, post-traumatic stress disorder (PTSD), suicidal ideations, and chronic pain.

Although the clinical use of ketamine infusions is mainly off-label, an increasing number of studies and clinical trials have shown irrefutable evidence of ketamine’s powerful therapeutic potential. Some medical experts have even gone so far as to call ketamine the biggest breakthrough in psychiatric care in the last 50 years.

How Does Ketamine Therapy Work?

Ketamine is a unique medication that works differently from traditional medications like antidepressants. Most psychiatric medications target and modulate certain chemicals in the brain, specifically neurotransmitters like serotonin and dopamine.

Ketamine, on the other hand, does not directly target any specific neurotransmitter. Instead, it works by binding to and blocking the N-methyl-D-aspartate (NMDA) receptor. The NMDA receptor is responsible for regulating glutamate, which is the brain’s primary excitatory neurotransmitter.

This initiates a cascade of events that trigger the formation of new healthy synapses in the brain, ultimately leading to improved brain signaling. This is the equivalent of “rewiring” the brain to ensure better communication between various regions.

The result is a rapid and significant improvement in emotional processing, cognition, and sensory processing – all of which are key areas of deficits in people diagnosed with mental illness or chronic pain.

What is Spravato?

Thanks to the high efficacy, rapid onset of action, and proven safety profile of ketamine infusions, the FDA approved a ketamine-based nasal spray called Spravato (esketamine) in 2019 for the treatment of refractory depression.

Spravato is made up of the S-enantiomer of ketamine, one of the two enantiomers (mirror images) that make up the ketamine molecule. Like ketamine, Spravato has a rapid antidepressant effect mediated by its interaction with the NMDA receptors.

Spravato is intended to be used in conjunction with oral antidepressant medication and must be administered under the supervision of a certified healthcare provider in a medically-supervised setting.

Can Spravato Help With Anxiety?

Although Spravato is strictly approved for treatment-resistant depression, its close relationship to ketamine begs the question of whether it could support other mental health conditions like anxiety.

Spravato is not FDA-approved currently for anxiety disorders specifically. However, given ketamine’s well-established efficacy in treating anxiety disorders, it is reasonable to assume that Spravato may also be effective for anxiety treatment, and is often used “off-label” for those conditions, especially in partnership with treatment-resistant depression. 

While clinical trials are needed to formalize this use case for Spravato treatment, anecdotal evidence based on patients with comorbid anxiety disorders suggests Spravato could significantly improve symptoms of anxiety disorders.

IV Ketamine vs. Spravato – Which Is Better?

If you’re considering ketamine treatment for your anxiety, you may be wondering whether ketamine infusions or Spravato would be a better option for you.

Both Spravato and ketamine infusions have proven to be highly effective in managing depression symptoms, and there is currently no scientific evidence to suggest one is better than the other. 

However, ketamine infusion therapy has a broader range of applications beyond depression, including the treatment of anxiety disorders, suicidal ideations, OCD, and chronic pain. IV ketamine therapy is also being investigated as a potential treatment for substance use disorders (SUD).

Additionally, ketamine infusion therapy allows for a higher level of control over the dosage. This is important because the therapeutic window of ketamine is very narrow – excessive doses can have undesirable side effects, while inadequate doses may not produce the desired therapeutic benefits.

The best way to determine which treatment option is best for you is to consult a board-certified ketamine provider who can perform a comprehensive evaluation and develop a personalized treatment plan.