Spravato or IV Ketamine Infusion: Which Option Is Right for You?

Spravato and IV ketamine differ mainly in how the medication enters the bloodstream. Spravato is the brand name for esketamine nasal spray, which is absorbed through the nasal lining. Because it is delivered intranasally, absorption can vary from patient to patient depending on nasal anatomy, technique, congestion, and other factors. The medication does not enter the bloodstream all at once, and the body absorbs only a portion of the administered dose. This makes Spravato different from IV ketamine, where the medication is delivered directly into the bloodstream through an intravenous line.

IV ketamine allows for more precise control over dose delivery, timing, and infusion rate. At Bay Area Ketamine Center in Los Altos, CA, Dr. Paul Wender, MD, and the team focus on medically supervised IV ketamine therapy, where the medication can be carefully administered and monitored in real time. Because Dr. Wender is a board-certified anesthesiologist with extensive experience in anesthesia, pain management, and ketamine infusion therapy, patients benefit from a highly controlled clinical setting designed to support safety, comfort, and individualized care.

A typical Spravato treatment session generally requires a longer appointment because patients must self-administer the nasal spray under medical supervision and then remain under observation for at least two hours. The monitoring period is required because Spravato may cause temporary sedation, dissociation, dizziness, blood pressure changes, or other short-term effects. This means the full appointment can take several hours, even though the actual nasal spray administration itself is brief.

An IV ketamine infusion for depression or mood-related concerns is often shorter in active treatment time, with many protocols using an infusion period of about 40 minutes. At Bay Area Ketamine Center, the visit also includes preparation, physician monitoring, recovery time, and discharge evaluation. Dr. Paul Wender, MD, and the clinical team create a calm, supportive environment where patients are monitored throughout the infusion and recovery period. This physician-led approach helps ensure that each patient receives attentive care before, during, and after treatment.

Spravato treatment is typically structured around an induction and maintenance schedule. For treatment-resistant depression, the labeled schedule often begins with twice-weekly sessions during the first four weeks, followed by a reduced frequency during maintenance depending on response and clinical judgment. This can require a significant time commitment, especially because each visit includes supervised administration and post-treatment monitoring. Patients considering Spravato should discuss the full schedule, eligibility, and monitoring requirements with a certified provider.

IV ketamine therapy is often delivered in a series of infusions, with the number of sessions tailored to the patient’s condition, symptom severity, treatment history, and response. Some clinical protocols use multiple infusions over a two-to-four-week period, followed by maintenance or booster infusions when appropriate. At Bay Area Ketamine Center, Dr. Paul Wender and the team personalize the treatment plan instead of using a one-size-fits-all approach. Patients are evaluated carefully so the care plan can be adjusted based on safety, tolerability, and measurable improvement.

Spravato and IV ketamine both act on the glutamate system and are used in the broader field of treatment-resistant depression care, but they are not identical treatments. Spravato is FDA-approved for treatment-resistant depression in adults and must be administered under specific safety requirements. IV ketamine for depression is commonly used off-label in specialized clinical settings and has been studied for its rapid antidepressant effects, particularly in patients who have not responded well to traditional medications.

The clinical difference often comes down to route of delivery, dosing flexibility, medical oversight, and patient-specific response. IV ketamine may offer more direct control over the infusion rate and dose, while Spravato follows a standardized nasal spray format and REMS-based administration requirements. At Bay Area Ketamine Center, Dr. Paul Wender, MD, uses his medical expertise to help patients understand whether IV ketamine therapy may be appropriate for their needs. His background in anesthesiology and neurobiology supports a careful, evidence-informed approach to treatment planning.

Dr. Paul Wender, MD, begins by reviewing the patient’s medical history, mental health history, current symptoms, prior treatments, medications, safety concerns, and overall goals. This consultation helps determine whether IV ketamine therapy at Bay Area Ketamine Center may be a suitable option. If a patient is specifically interested in Spravato, Dr. Wender can help explain how Spravato differs from IV ketamine in general terms and encourage the patient to discuss Spravato eligibility with a REMS-certified provider or their prescribing mental health clinician.

At Bay Area Ketamine Center, the focus is on providing safe, physician-supervised ketamine infusion therapy in a professional clinical environment. Dr. Wender and his team consider factors such as treatment-resistant depression history, anxiety symptoms, PTSD symptoms, chronic pain concerns, medication tolerance, medical risk factors, and patient preferences. This individualized evaluation helps patients make informed decisions about their care while receiving guidance from an experienced physician who understands the medical, neurological, and emotional aspects of ketamine therapy.

Patients choose Dr. Paul Wender, MD, at Bay Area Ketamine Center because of his strong medical background, board-certified anesthesiology training, and extensive experience guiding patients safely through ketamine infusion therapy. His understanding of anesthesia, monitoring, medication response, and patient comfort is especially important for individuals seeking ketamine treatment for depression, anxiety, PTSD, chronic pain, or treatment-resistant mood concerns. With physician-led care, patients receive a level of medical oversight that supports both safety and confidence.

The team at Bay Area Ketamine Center is dedicated to creating a compassionate, supportive, and carefully monitored treatment experience. From the first consultation to follow-up care, patients are treated as individuals with unique symptoms, histories, and goals. Dr. Wender’s approach emphasizes education, safety, realistic expectations, and personalized treatment planning. For patients comparing IV ketamine with other options such as Spravato, Bay Area Ketamine Center provides clear guidance while focusing on the IV ketamine services available through the clinic. For more information, contact us or schedule an appointment online. We are conveniently located at 746 Altos Oaks Drive Suite B, Los Altos, CA 94024. We serve patients from Los Altos, CA, Sunnyvale, CA, Palo Alto, CA, Stanford, CA, Atherton, CA, Cupertino, CA, Santa Clara, CA, Mountain View, CA, Loyola, CA, and surrounding areas.