Esketamine, marketed by Janssen Pharmaceuticals as Spravato™, made waves when it was approved by the FDA in 2019. This “revolutionary” antidepressant nasal spray drug was touted as an effective option for individuals suffering from treatment-resistant depression—and it is! Once the dust settled, however, questions and concerns started arising from the professional mental health community, who had a different opinion about the drug.

The biggest drawback to Spravato, out of the gate, is the cost. Preliminary analysis shows that the price of the medicine would need to be cut between 25-50% in order to be cost-effective. Dose depending, initial estimates are between $590 and $900 per treatment session—and this is just the cost for the medication itself. Added to this price tag is the cost of the office visit, as Spravato can only be administered in a doctor’s office under close supervision. For an entire year, the cost of treatment could reach $50,000 which, for a majority of patients, makes Spravato inaccessible.

Esketamine was also hailed as a breakthrough drug, when, in all reality, it’s cut from the same cloth as ketamine. The Esketamine molecule is essentially a mirror image of the ketamine molecule. However, ketamine has been around since the 1970s. Its patent had long expired, and there was no hope that any pharmaceutical company could make money off of it, hence the development of a new, patentable drug that would be profitable. Ketamine is available for a fraction of the cost of Spravato and has been backed by numerous studies that demonstrated its effectiveness in treating depression…scientific support that Spravato lacked.

It is unclear based on the clinical trials if Spravato is more or less effective than ketamine. A report was published after FDA approval that claimed Spravato’s benefit was modest, and that it only performed better than placebo in two of three studies submitted to the FDA. This may be due to the delivery system (nasal spray) of Spravato where the absorption rate is widely variable (25-50%) compared to ketamine therapy, which is 100% when administered intravenously. Another theory regarding the poor performance of Spravato is that only the chemical effects of the medication were tested. The most effective depression treatment is a combination of Spravato with additional antidepressant medication or psychotherapy.

All in all, Spravato may be a viable treatment option for some…but not for most. IV ketamine therapy is widely available for those who meet the criteria for this type of treatment. It is more cost-efficient and has research to back its effectiveness in treating treatment-resistant depression.

If you struggle with mental health issues, contact our ketamine infusion therapy center today for a free consultation, or simply complete the brief form below and a member of our clinical team will reach out to answer your questions, determine if you’re a candidate for ketamine infusion therapy, and address your concerns.


Contact VIP Ketamine Clinics

Our Modesto, CA ketamine clinic offers ketamine infusions for a variety of mental health disorders, such as depression, anxiety, PTSD, and bipolar disorder. Our first priority is the emotional, mental and physical wellbeing of our patients. If you or a loved one are suffering from a psychiatric disorder, contact our ketamine clinic for a free consultation. We will help point you in the direction of health and wellness, whatever direction that may be.