Ketamine therapy has changed the landscape of mental health care, especially for people who have not found relief with traditional medications. At Flow Wellness, we believe in clear education and personalized care, so patients understand their options and can choose the approach that best supports their healing.
Ketamine is not a one-size-fits-all treatment. The way it is delivered matters. Below, we break down the three most common forms of ketamine therapy—IV ketamine, Spravato, and oral dissolving tablets—and explain how they compare.
How Ketamine Works for Mental Health
Ketamine works differently than standard antidepressants. Instead of slowly adjusting serotonin or dopamine over weeks, ketamine acts on the glutamate system in the brain. This can help create new neural connections, improve brain flexibility, and reduce symptoms of depression, anxiety, PTSD, and suicidal thoughts more rapidly.
The delivery method affects how much ketamine reaches the brain, how predictable the response is, and how closely treatment can be tailored to the individual.
IV Ketamine: The Gold Standard
IV ketamine is widely considered the gold standard for ketamine therapy—and for good reason.
With IV treatment, ketamine is delivered directly into the bloodstream. This allows for nearly 100% bioavailability, meaning your body receives the full therapeutic dose. Because it is administered in a medical setting, dosing can be precisely adjusted based on your weight, response, and treatment goals.
Key advantages of IV ketamine:
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Strongest and most consistent therapeutic effect
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Fully customizable dosing
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Rapid onset and predictable response
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Continuous medical monitoring during treatment
IV ketamine is especially helpful for patients with severe depression, treatment-resistant symptoms, or those who need a higher level of support and structure. At Flow Wellness, IV ketamine is overseen by experienced clinicians in a calm, supportive environment focused on safety and comfort.
Spravato: Insurance-Covered, Highly Structured
Spravato is an FDA-approved nasal spray form of esketamine, a derivative of ketamine. One of its biggest advantages is that it is often covered by insurance, making it more accessible for some patients.
However, Spravato comes with strict protocols. Treatments must be done in a certified clinic, patients must stay for observation afterward, and dosing options are limited.
Key features of Spravato:
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Insurance coverage is often available
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Only two fixed dose options
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Must follow rigid FDA-mandated protocols
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Less flexible than IV ketamine
While Spravato can be effective, the lack of dose customization means it may not work equally well for everyone. Some patients respond well, while others find the effects more limited compared to IV ketamine.
Oral Dissolving Tablets: Convenience at Home
Oral ketamine dissolving tablets (also called troches or lozenges) offer a more convenient, at-home option. These treatments are prescribed and taken under guidance, but they do not require clinic visits for each session.
This approach can be appealing for patients who value flexibility or live far from a clinic. However, oral ketamine has lower bioavailability, meaning less of the medication reaches the brain compared to IV treatment.
Important considerations for oral ketamine:
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Can be taken at home
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Requires a trusted person present during sessions
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Effects are typically milder than IV ketamine
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Less precise dosing and variability in absorption
Oral ketamine can be a supportive option for maintenance or for patients with milder symptoms, but it is generally not as powerful or predictable as IV therapy.
Choosing the Right Option for You
Each form of ketamine therapy has a place in mental health care. The best choice depends on your symptoms, treatment history, lifestyle, and goals.
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IV ketamine offers the most robust and individualized treatment
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Spravato provides an insurance-covered option with structured protocols
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Oral dissolving tablets offer convenience with lower intensity and more variability
At Flow Wellness, we take time to understand your story and guide you toward the option that makes the most sense for your needs—while prioritizing safety, effectiveness, and long-term progress.
A Thoughtful Path Forward
Ketamine therapy can be life-changing, but the details matter. Delivery method, dosing, and clinical support all play a role in outcomes. By understanding the differences, you can make informed decisions and feel confident in your care.
If you are exploring ketamine therapy and want expert guidance, Flow Wellness is here to help you take the next step—at a pace that feels right for you. Schedule a no-charge informational phone call with one of our ketamine providers.
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