Spravato contains esketamine, one specific form of ketamine that has been FDA-approved and studied in large clinical trials.
Ketamine treatments typically use racemic ketamine and are offered off-label for depression.
The main differences are:
Spravato is FDA-approved for depression
Spravato is given as a nasal spray in clinic
Ketamine is usually given by IV or IM in clinic
Spravato follows a strict monitoring and REMS safety program
Both treatments work through similar brain pathways, but they are delivered and regulated differently.