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Ketamine vs. Spravato in Jacksonville, FL
Two forms of the same medicine. One right choice for you.
IV ketamine and Spravato (esketamine) are close cousins — but they differ in how they're given, how precisely they're dosed, and most importantly, how well they tend to work. With insurance, Spravato can look like the cheaper option. But the real question isn't which costs less per visit — it's which one is most likely to actually lift your depression. A treatment that doesn't work isn't a bargain at any price.
Side by side
The practical differences that actually affect you
Beyond the chemistry, the two treatments differ in the ways that shape your experience: approval status, insurance, cost, visit schedule, and dosing control.
| IV ketamine | Spravato (esketamine) | |
|---|---|---|
| What it is | Racemic ketamine (both R- and S-molecules), delivered by IV | Esketamine — the S-molecule only — as a nasal spray |
| FDA status | FDA-approved anesthetic, used off-label for mood conditions | FDA-approved for treatment-resistant depression |
| Insurance | Rarely covered; superbill provided for out-of-network claims | More commonly covered for TRD; copays and clinic fees vary |
| Cost at a glance | $399–$549 per infusion at The Practice, all-inclusive | Depends on your plan — low copay to significant out-of-pocket |
| Typical first month | Six infusions over about four weeks | Twice-weekly sessions, each with 2+ hours of required monitoring |
| Dosing precision | Dose titrated continuously by your provider during the infusion | Fixed spray doses; absorption varies person to person |
| Where to get it in Jacksonville | The Practice, San Marco — free consultation currently | REMS-certified Spravato clinics and some VA facilities |
Keep the comparison honest with yourself: a low copay only saves you money if the treatment works. The research below shows how the two compare where it matters most. For the complete money side — package totals, financing, superbills — see our ketamine cost & pricing page.
What the research shows
IV ketamine vs. Spravato
Systematic reviews of separate controlled trials have reported larger pooled short-term effects for IV ketamine on several measures. These are indirect comparisons — direct head-to-head evidence remains limited.
Response compared with placebo
Pooled relative likelihood of a clinically meaningful reduction in depression symptoms
RR 3.01
Larger pooled relative effect
RR 1.38
Remission compared with placebo
Pooled relative likelihood of reaching few or no remaining depression symptoms
RR 3.70
Larger pooled relative effect
RR 1.47
Pooled symptom improvement
Standardized effect size across separate controlled trials; study designs and populations varied.
Hedges’ g 1.52
Larger pooled effect size
Hedges’ g 0.31
Number needed to treat (NNT)
Lower NNT means fewer people need treatment for one additional person to respond compared with placebo.
✓ NNT 3 from day 1 to week 1; NNT 9 at 4 weeks
— NNT 2 at day 1; NNT 11 at 4 weeks
Sources: Bahji et al. (2021) Seshadri et al. (2024) Calder et al. (2024) . Figures are relative effects versus placebo or pooled effect sizes from systematic reviews and meta-analyses of depression trials.
Individual results vary. Ketamine therapy is not appropriate for everyone — candidacy is determined during a comprehensive medical consultation.
Decision guide
Which one fits your situation?
Insurance coverage makes Spravato tempting on paper. But depression treatment is measured in one currency: whether you get better. Weigh the research above alongside your coverage, your history, and how quickly you need relief:
IV ketamine tends to fit when…
- You are self-paying or have a high deductible and want one transparent price
- You want provider-titrated dosing rather than a fixed spray
- Faster initial relief matters — research suggests IV often acts sooner
- You want fewer visits in the first month (6 vs. ~8 with Spravato)
Spravato may still make sense when…
- Your insurance covers Spravato with a low copay
- You strongly prefer an FDA-approved, on-label treatment
- You are a veteran — the VA covers Spravato for qualifying TRD
- Needles are a hard no for you
Even then, run the numbers on the full course — twice-weekly visits, two-plus hours of monitoring each, copays and deductibles — and weigh them against the pooled response rates above. Many patients who plateau on Spravato go on to try IV ketamine.
Veteran? The VA covers Spravato for qualifying treatment-resistant depression, and IV ketamine occasionally through Community Care. Start with our guide: Ketamine treatment and the VA.
Common questions
Ketamine vs. Spravato, answered
What is the difference between ketamine and Spravato?
Ketamine is the full racemic molecule (R- and S-forms), typically given by IV infusion and used off-label for depression, anxiety, PTSD, and pain. Spravato is esketamine — just the S-molecule — delivered as a nasal spray and FDA-approved specifically for treatment-resistant depression. They are closely related medicines with different delivery, approval status, and insurance treatment.
Which works better, IV ketamine or Spravato?
Head-to-head evidence is limited. Pooled analyses of separate trials have reported larger short-term effects for IV ketamine on response and remission, while a 2025 meta-analysis found no significant difference in overall response by the end of acute treatment — though IV often produces faster initial improvement. The honest answer: both work, and the right choice depends on your insurance, history, and preferences.
Which is cheaper in Jacksonville?
Per visit, Spravato with good insurance may cost only copays, while IV ketamine at The Practice is $399–$549 per all-inclusive infusion. But the honest math includes effectiveness: a treatment course is only worth what it does for your depression. Pooled research has shown roughly two to three times the relative likelihood of response and remission with IV ketamine, and without insurance Spravato’s medication plus monitoring fees often cost as much as infusions or more. Our cost page has the full comparison.
Does The Practice offer Spravato?
We offer IV ketamine infusions exclusively — a deliberate clinical choice. Infusions let a board-certified psychiatric provider titrate your dose precisely in real time, and pooled research has shown larger short-term effects on response and remission than esketamine. Every infusion at The Practice is delivered in a private room with continuous monitoring.
Can I switch from Spravato to IV ketamine, or vice versa?
Yes, in either direction, under proper medical guidance. Some patients who plateau on one form respond to the other. Bring your treatment records to your consultation and our team will help you plan the transition safely.
I’m a veteran — which does the VA cover?
The VA covers Spravato for veterans meeting treatment-resistant depression criteria. IV ketamine is generally not covered directly, though Community Care authorization is possible in limited cases. Our guide to ketamine and the VA walks through both paths step by step.
The ketamine resource center
Keep exploring ketamine therapy
Ketamine Infusion Therapy →
The main guide to IV ketamine at The Practice — conditions, research, and booking.
Treatment-Resistant Depression →
When two or more antidepressants haven’t worked — what ketamine offers TRD.
Ketamine for Anxiety →
Rapid relief for persistent anxiety, panic, and nervous-system activation.
Ketamine for PTSD →
Trauma-informed infusion care for hypervigilance and flashbacks.
Ketamine for Chronic Pain →
CRPS, neuropathy, migraines, and centralized pain protocols.
Cost & Pricing →
Transparent pricing: $399–$549 per infusion, financing, and insurance notes.
What to Expect →
Your first infusion, hour by hour — preparation, the experience, and recovery.
How It Works →
The science: the glutamate surge and the dendritic spine regrowth seen in research.
What Is Ketamine Therapy? →
The complete beginner’s guide: history, mechanism, safety, and evidence.
Veterans & the VA →
How VA coverage works for Spravato and IV ketamine, and the Community Care path.
Ketamine FAQ →
Every common question about ketamine in Jacksonville, answered in one place.
Get an honest recommendation — free
Our psychiatric team reviews your history, your insurance, and the treatments you've tried, then gives you a straight answer about your best chance of getting better — and exactly what it will cost, in writing. Consultations are currently free.
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