Which Type Of Ketamine Therapy Is Best?
Psychedelic Assisted Psychotherapy
When you first discover ketamine, a powerful therapeutic treatment which can be used to help people with PTSD, anxiety, and depression, it’s understandable to have a lot of questions. One of the first questions a patient has is how the medicine is administered.
The most well-known delivery system for ketamine is an IV, which sends medicine directly into the bloodstream via a needle. Chances are, you’ve received some type of IV at least once in your life since it’s an efficient way to deliver medicine quickly (such as for pain relief or when dehydrated). Most patients new to ketamine therapy think the only way to receive this alternative treatment is through an IV. This is a misconception popularized by news stories about ketamine clinics.
There are actually other (less invasive) ways to receive ketamine therapy that are also effective. Since each route of administration has its own benefits and drawbacks, patients often wonder, “Which treatment method should I use? Which is best for me?”
First, before starting any new treatment, talk to your doctor or a licensed clinician. He or she can go into further detail about each delivery method.
To get you familiar with what to expect and with the different options available, the list below explains each type of delivery system, the pros and cons, and the average costs. Gaining as much knowledge as you can about ketamine treatment means you can advocate for yourself and find the best plan for your individual needs.
Since this is the most popular delivery system, this is a good starting point. Intravenous or IV therapy administers ketamine into the bloodstream via a needle or catheter. The major advantage of this option is that the ketamine can be administered into the body precisely over a period of time.
Patients seeking an alternative treatment for depression and other issues often travel to outpatient IV clinics. They spend around 45 minutes to several hours (depending on the condition being treated) with a practitioner who administers the ketamine. Once treatment ends, the patient cannot drive safely, so transportation must be arranged.
Clinics that focus on IV treatments achieve the most success when helping patients with neuropathic pain conditions like Fibromyalgia and Complex Regional Pain Syndrome (CRPS). When treating debilitating chronic pain, patients need extended infusions (up to four hours), making IV delivery an ideal option. This is considered a “low and slow” approach to ketamine therapy.
Clinics offering ketamine for anxiety or other mental health conditions also have high success rates; however, the price tag for the patient is high. Many people struggle to pay for the treatment out of pocket when insurance offers zero or little coverage. Cost and location are the largest barriers for IV ketamine therapy.
Pros of intravenous treatment:
- Delivered in a clinic over a period of time
- Great success rates
- Best for chronic pain conditions
Cons of intravenous treatment:
- High cost
- Requires a longer time commitment for each session
- Transportation must be arranged
- Not suited for those who get queasy around needles
- Access may be difficult in rural regions
How much does intravenous ketamine treatment cost?
On average, ketamine infusion clinics cost anywhere from $500 to $800 per treatment. The first month of treatment typically calls for multiple sessions. Total, the first month can cost anywhere from $2,000 to $4,000. After that, patients usually return for one treatment a month.
Intranasal / Spravato Nasal Spray
Off-label ketamine nasal sprays have been on the market for some time, but they gained national attention when the FDA approved Spravato in 2019. This nasal spray uses a variation of ketamine as an alternative treatment for depression in patients who can’t find relief any other way. Nasal sprays can be an ineffective delivery system at times because of fluctuations in each spray and individual differences in intranasal absorption rates.
Currently, esketamine-based nasal sprays are only prescribed to those with Treatment-Resistant Depression. If you suffer from other conditions like chronic pain, PTSD, or anxiety, you most likely won’t be a candidate. Spravato patients also cannott self-administer, so they must go to a clinic for monitoring.
Pros of intranasal treatment:
- Spravato is FDA-approved for Treatment-Resistant Depression
Cons of intranasal treatment:
- Only available to select patients
- Often ineffective delivery system
- Must get each dose at a clinic
- Cost is high if insurance does not provide coverage
Known as ketamine sublingual tablets, oral ketamine is an easily absorbable way to receive therapy. Each ketamine tablet dissolves under the tongue and will take effect in about 10-15 minutes. Treatment is meant to be done at home, but it can also be done in an outpatient setting at a clinic. Oral ketamine has an excellent safety record and high absorption rates.
One drawback is that dosing is not as precise as an IV, but instead falls in a range. Regardless, many patients find it more accessible with low side effects. It can also be self-administered safely at home under supervision versus needing to travel to a clinic.
Pros of oral ketamine treatment:
- Least invasive delivery system
- Convenience: can be taken at home
- Access: compound pharmacies can deliver anywhere in US
Cons of oral ketamine treatment:
- Not as precise dosing as intravenous delivery
How much does oral ketamine treatment cost?
Oral ketamine is the most affordable option, and prices can be as low as $149 per treatment.
Receiving ketamine therapy as an alternative treatment for depression, PTSD, chronic pain, OCD, and other mental health conditions can be a life-changing experience. There are several options for receiving therapy, each with pros and cons. Ultimately, which option you choose depends on what you feel will best suit your individual needs. A clinician can help answer any further questions so you can develop the best possible plan to start on your journey.
Dr. Zand has merged his passions for lifestyle medicine, performance coaching, and entrepreneurship to establish platforms which build leaders and self-healers in the community. Dr. Zand specializes in psychiatric care for peak performance with executives, professional athletes and has helped countless high-performers optimize their mental health. Sam is a psychiatrist with years of experience working with ketamine and other psychedelic medicines in both research and clinical settings.