Plain disclosure: Music City Ketamine offers IV ketamine infusions. We do not offer Spravato. If Spravato fits your situation better, we will tell you so, and your psychiatrist or a certified Spravato treatment center can help.
What each one is
Spravato is a brand-name nasal spray containing esketamine, one of the two mirror-image forms (enantiomers) that make up ketamine. The FDA approved it in 2019 for adults with treatment-resistant depression, and later for depressive symptoms in adults with major depressive disorder with acute suicidal thoughts or actions. In January 2025 the FDA also approved it as a stand-alone (monotherapy) treatment for adults with treatment-resistant depression.1,2
IV ketamine is generic ketamine given through an intravenous line. Ketamine is FDA-approved as an anesthetic. Its use for depression, anxiety, PTSD and chronic pain is off-label, meaning a licensed clinician prescribes it for a use the FDA has not specifically approved.3
Side by side
| Spravato (esketamine) | IV ketamine | |
|---|---|---|
| How it's given | Self-administered nasal spray, under supervision in a certified healthcare setting | Intravenous infusion given by a licensed clinician |
| FDA status for depression | FDA-approved for the indications above | Off-label |
| Where | Only at healthcare settings certified under the Spravato REMS program; it cannot be taken home4 | Clinic setting; at Music City Ketamine, administered by Marla Peterson, CRNA |
| Monitoring | Patients are observed by a healthcare provider for at least 2 hours after each dose, per the REMS program4 | At Music City Ketamine, continuous anesthesia-level monitoring of vital signs during the infusion |
| Dosing | Fixed doses set by the FDA label | Dose and infusion rate set by the clinician for each patient |
| Insurance | Often covered by insurance, subject to each plan's rules and prior authorization | At Music City Ketamine, self-pay; HSA/FSA accepted and superbills provided for possible out-of-network reimbursement. Coverage is not guaranteed. |
| Getting home | Patients should not drive until the next day after a full night's sleep, per the label1 | A driver is required after every infusion |
Which is right for you?
That's a medical decision to make with your prescriber, based on your history, current medications, insurance and preferences. Neither treatment works for everyone, and response varies. A free phone consultation with our team is a no-pressure way to ask questions about IV ketamine, including whether Spravato may be the better first step for you.
Sources
- FDA prescribing information, SPRAVATO (esketamine) nasal spray
- Johnson & Johnson, Spravato monotherapy approval, January 2025
- FDA: ketamine is approved for general anesthesia, not for depression or chronic pain (2024)
- SPRAVATO REMS program
This page is general information, not medical advice. Last reviewed October 28, 2026.