Esketamine vs IV Ketamine — What’s the Difference?

A New Chapter in Mental Health Treatment

Ketamine therapy has been gaining attention as a breakthrough option for depression, anxiety, and trauma that have not responded to traditional treatments.
If you have heard of Esketamine (Spravato®) and IV Ketamine, you might be wondering what the difference is.
Let’s clear it up.

How They Are Given

• IV Ketamine:
  The original and most widely used form. It is administered through an IV infusion, allowing the full ketamine compound (called racemic ketamine) to enter your bloodstream directly.

• Esketamine (Spravato®):
  Esketamine is an FDA-approved nasal spray that uses only one half of the ketamine molecule, the “S” form. It is taken under medical supervision in a certified clinic.

How They Work in the Brain

Both treatments act on NMDA receptors, helping reset the brain’s communication patterns and boost neuroplasticity (the brain’s ability to form new connections).
This “reset” helps relieve symptoms of depression and anxiety, sometimes within hours.

The main difference:

• IV Ketamine uses both the R and S forms of the molecule, often resulting in a broader and sometimes deeper effect.

• Esketamine, being just the S form, can offer a gentler experience that some patients prefer.

Insurance and Accessibility

• Esketamine: Covered by many insurance plans because it is FDA-approved for depression.

• IV Ketamine: Used off-label for mental health, meaning it is often self-pay. Many clinics offer payment options to make it accessible.

The Experience

IV ketamine infusions can produce a more immersive, meditative, or introspective state.
Esketamine sessions are shorter and may feel milder or easier to navigate for first-timers.

Neither is better. It depends on your comfort level, health history, and treatment goals.

The RealShift Elevated Approach

At RealShift Elevated, we tailor each treatment plan to the individual. Whether you choose IV Ketamine or Esketamine, you are supported by a compassionate team focused on your comfort, safety, and healing.

Ready to learn more or explore which therapy fits your needs best?
👉 Schedule a consultation with RealShift Elevated and start your path toward mental clarity and emotional balance.