IV Ketamine vs. Esketamine (Spravato): A Comprehensive Guide to Effective Depression Treatment at Scenic City Neurotherapy
By Charles Miller, CRNA, CMO, Founder/Owner of Scenic City Neurotherapy
For individuals facing treatment-resistant depression (TRD), PTSD, anxiety, OCD, or chronic pain, traditional medications don’t always deliver the relief they need. Ketamine therapy has long been recognized for its rapid and transformative results, making it a powerful first-line option for those seeking effective, lasting change.
With a proven track record and years of clinical use, ketamine stands out as a trusted approach. That said, not all ketamine therapies are created equal, and each comes with a ceiling on its potential success. Understanding those limits helps you choose the option with the highest likelihood of lasting results.
At Scenic City Neurotherapy, we specialize in IV Ketamine Infusion Therapy, utilizing our Minimally Stimulated Ketamine Infusion Therapy (MSKIT®) protocol.
This definitive guide examines the critical differences between:
✔ IV Racemic Ketamine (our specialty)
✔ Intranasal Esketamine (Spravato nasal spray)
We’ll explore science-driven outcomes, treatment protocols, and why our patients consistently achieve better results with MSKIT® than with Spravato.
Understanding Ketamine: How It Works Differently Than Antidepressants
Traditional SSRIs and SNRIs work slowly (over weeks or months) by altering neurotransmitter levels. Ketamine acts within hours by:
- Stimulating a neuro-regenerative protein, BDNF (Brain-Derived Neurotrophic Factor), to repair damaged neural pathways
- Enhancing neuroplasticity, effectively rewiring neural pathways
However, the type of ketamine and delivery method drastically impact effectiveness.
Racemic Ketamine vs. Intranasal Esketamine (Spravato): Key Differences
| Feature | IV Ketamine (Racemic Ketamine) | Intranasal Esketamine (Spravato) |
| Composition | Contains both R- and S-ketamine | Only S-ketamine |
| Bioavailability | 100% (direct bloodstream delivery) | 8-40% (depends on anatomy and allergies) |
| Dosing | Fully customizable to the individual | Only two fixed doses (56mg or 84mg) |
| Administration | Controlled IV infusion (adjustable/pausable) | Single nasal spray (no adjustments) |
| Neuroplasticity | Optimal release of BDNF (necessary for neuro-regenerative effects) | Limited, if any, neuro-regenerative effects |
Why Scenic City Neurotherapy’s MSKIT® Protocol Outperforms Standard Treatments
The MSKIT® Difference
Unlike other ketamine therapy protocols, our Minimally Stimulated Ketamine Infusion Therapy (MSKIT®) focuses on:
- Education
- Comfort
- Safety
- Proven Results
Proven Results: Our Clinical Data
Our 2022-2024 study analyzed 252 patients receiving MSKIT® for depression:
- 82% response rate (Patients reported more than 50% relief of depressive symptoms)
- 15% Partial Response rate (Patients reported between 20-50% relief of depressive symptoms)
- 3% No meaningful response (Patents reported less than 20% relief of depressive symptoms)
Compared to Spravato, MSKIT® outcomes are stronger; Spravato’s response rates have not been shown to differ significantly from those of antidepressants or intranasal placebo in clinical studies (Janssen Research & Development, LLC).
Ketamine Therapy Process at Scenic City Neurotherapy
- No-Cost Consultation (60 minutes)
- Initial Stabilization Phase (6 infusions over 3 weeks)
- Maintenance Phase (patient-driven follow-up boosters)
- Post-Stabilization Success Plan (therapy, lifestyle, environment, etc.)
Unlike Spravato, which requires twice-weekly clinic visits, our model is patient-driven and backed by long-term results.
Spravato (Esketamine): Pros, Cons, and Hidden Costs
Potential Benefits
✔ FDA-approved (may be covered by some insurance plans)
Significant Drawbacks
- Lacks neuroregenerative benefits critical for success
- Low & inconsistent absorption (8-40% bioavailability)
- Fixed dosing (no adjustments for individual needs)
- Long-term in-office visits (2x/week, then decrease to 1x/week, followed by bi-weekly or weekly sessions, and potentially continue indefinitely)
While insurance coverage may seem appealing, many patients find:
-
- IV ketamine is more cost-effective long-term (due to its effectiveness, requiring fewer treatments long-term)
- IV ketamine provides faster, more reliable relief
Direct Comparison: Why IV Ketamine Is Superior
| Factor | IV Ketamine at Scenic City | Spravato |
| Dosing | ✔ Fully customized | ✖ Fixed dosing |
| Absorption | ✔ 100% bioavailability | ✖ 8-40% absorption |
| Control | ✔ Adjustable throughout treatment | ✖ No adjustments once given |
| Response Rates | ✔ 82% (MSKIT® data) | ✖ ~50-60% |
| Convenience | ✔ 2x/week for 3 weeks then as needed, flexible maintenance | ✖ 2x/week, then decrease to 1x/week, followed by bi-weekly or weekly sessions, and potentially continue indefinitely |
Why Choose Scenic City Neurotherapy?
In all published research on ketamine, across every method of administration, Scenic City Neurotherapy’s Minimally Stimulated Ketamine Infusion Therapy (MSKIT®) consistently yields the highest patient-reported relief from depressive symptoms.
Take the Next Step Toward Healing
If you’re ready for a treatment that works when others haven’t, explore:
Contact Us Today
Call: (423) 228-0579
Email: admin@sceniccityneurotherapy.com
According to Thomas Insel, former Director of the National Institute of Mental Health, IV ketamine remains the gold standard for rapid, lasting relief. With higher response rates and a track record of success, our MSKIT® protocol offers what Spravato simply can’t match.
Don’t settle for partial solutions, choose the treatment backed by evidence, expertise, and success.
Schedule a No-Cost Consultation with Scenic City Neurotherapy to begin your healing journey today.
About Scenic City Neurotherapy
Founded in 2019, Scenic City Neurotherapy is at the forefront of advanced and comprehensive treatments for those facing treatment-resistant conditions. Our mission is to optimize brain function and elevate well-being through cutting-edge therapies. We specialize in two pioneering approaches: Minimally Stimulated Ketamine Infusion Therapy (MSKIT®) and Transcranial Magnetic Stimulation (TMS).
If you are exploring innovative solutions for mental health, chronic pain, and other neuro-degenerative conditions, Scenic City Neurotherapy offers transformative treatment options. Join us in leading the charge towards groundbreaking brain optimization treatments and empowering individuals to reclaim their lives.
Contact Founder and Chief Medical Officer, Charles Miller today to learn more about our proven protocols for Minimally Stimulated Ketamine Infusion Therapy (MSKIT®). Call 423-228-0579 or visit www.ScenicCityNeuro.com.
