Quick Answer
Spravato (esketamine) is an FDA-approved nasal spray with specific insurance coverage and a structured administration protocol in REMS-certified settings. IV ketamine is a low-dose infusion used off-label for depression, with strong supporting research but no FDA approval for this use — so it's typically self-pay. Both require in-clinic administration with the 2-hour monitoring window. The right choice usually comes down to insurance coverage and clinical fit, which we work through together at your evaluation visit.
This question comes up frequently for patients researching ketamine therapy for depression at Good Health NC in Knightdale, NC.