IV Ketamine vs Intranasal Ketamine-Esketamine


IV Ketamine vs Intranasal Ketamine-Esketamine


We at MindScape Ketamine & Infusion Therapy, PLLC are ecstatic to hear that the FDA panel jointly voted to recommend the approval of nasal Ketamine (Esketamine) for treatment-resistant depression.

It will be prescribed under the name SPRAVATOTM by Johnson & Johnson. If approved Esketamine will be the 1st anti-depressant in 30 years to use a different mechanism to treat this leading cause of disability in the world.

This blog will focus on the difference between IV Ketamine and Esketamine.

IV Ketamine

MindScape Ketamine & Infusion Therapy, PLLC is THE premier concierge IV Ketamine clinic in Houston for the treatment of depression, anxiety, OCD, PTSD, and chronic pain conditions.

We focus on creating the most serene spa-like experience for our clients while they are undergoing their tailored-specific IV Ketamine treatment.

The obvious difference is that Ketamine is given to the patients via an IV. The precise dosage is delivered to the clients by a syringe pump over 40 minutes. Therefore this allows for a slow controlled buildup of the effects of the Ketamine.

Our clients describe the experience relaxing and peaceful. They report changes in their vision and a feeling of “lightheadedness” or “floating.” Many also describe being disassociated from their surroundings and having slower thoughts.

What is dissociation? It is a temporary mental state in which a person ‘detaches’ from the surroundings, meaning a person becomes less aware of what is around one and starts to feel disconnected from one’s body.

Some studies have found that patients who experience greater dissociation during ketamine infusions have greater antidepressant benefit.

One theory regarding this correlation is that these individuals have a GREATER Glutamate release. As a result, a greater dissociation.

IV Ketamine prevents the reuptake of the Glutamate neurotransmitter which allows it to be more readily available. This in turns works on various areas of the brain to quickly lessen depression, anxiety, OCD, PTSD, and chronic pain symptoms.

After the 40-minute infusion is completed, there is a 20-minute post-infusion recovery phase from the disassociation before the client is discharged home.

Intranasal Ketamine (Esketamine)

We at MindScape Ketamine & Infusion Therapy, PLLC have been experimenting with intranasal Ketamine in anticipation of its FDA approval for treatment resistant depression.

Esketamine’s obvious difference is that it is administered intranasally. This is advantageous for those clients who are difficult to obtain IV access.

This was also a deterrent for some of our clients due to the burning and stinging effects of the Esketamine as it touched the back of the nose and ran down the throat. We are interested to know if J&J took this into consideration for SPRAVATO.

Esketamine also differs in that the disassociation and “floaty” feeling comes on abruptly and strongly. Unlike IV Ketamine there was no slow buildup up to a calm and relaxed state.

Like IV Ketamine, Esketamine requires a clinic visit for its administration. It requires a medical professional setting due to its elevation of blood pressure potential as well as its dissociative effects. Two visits weekly is the established protocol for intranasal administration.

Esketamine also requires the patient to be simultaneously on a new oral anti-depressant. The FDA approval of Esketamine was based on trials with its use in conjunction with Lexapro, Cymbalta, Effexor, or Zoloft. IV Ketamine does not require additional drugs for it to be effective.

Lastly, Esketamine is FDA approved ONLY for the treatment of treatment resistant depression. IV Ketamine has been shown to alleviate or minimize various mood disorders such as depression, anxiety, OCD, PTSD, and certain chronic pain conditions.


MindScape Ketamine & Infusion Therapy, PLLC believes that the FDA approval of Esketamine will hopefully be a segue to its approval of IV Ketamine soon.

This revolutionary and effective treatment for depression, anxiety, OCD, PTSD, or various chronic pain conditions gives hope to those who have suffered for so long.

Please schedule a COMPLIMENTARY consultation with MindScape Ketamine & Infusion Therapy, PLLC so that we may help you Live Life Again.

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By Dr. Quang Henderson

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