📊 Evidence Supporting Ketamine Therapy

1. Rapid Reduction in Depression:

A landmark study in Biological Psychiatry (Zarate et al., 2006) showed that a single IV infusion of ketamine led to a significant reduction in depressive symptoms within 4 hours, with peak effects at 24–72 hours.

Zarate et al., 2006 – Biol Psychiatry

2. Efficacy for Suicidal Ideation:

A randomized trial in The American Journal of Psychiatry (2018) found that ketamine significantly reduced suicidal thoughts within 24 hours, even in severely depressed individuals.

Grunebaum et al., 2018 – Am J Psychiatry

3. FDA Approval of Spravato® (Esketamine):

Spravato (a nasal form of esketamine) is FDA-approved for:

• Treatment-resistant depression

• Major depression with acute suicidal ideation or behavior

This reflects a growing consensus on the safety and efficacy of ketamine derivatives in psychiatric treatment.

IV Ketamine vs. Spravato® (Esketamine): What’s the Difference?

At SOKA Wellness, we offer two forms of ketamine-based treatment for depression and suicidal ideation: IV ketamine infusions and Spravato® (esketamine) nasal spray. Both are effective, FDA-recognized treatment options — but they differ in how they're delivered, regulated, and processed by the body.

🔹 IV Ketamine Infusion

• What it is: Racemic ketamine (the full ketamine molecule) delivered via intravenous (IV) drip

• How it's administered: Over 40–60 minutes in a calm, monitored setting

• FDA approval: Off-label use for depression — backed by strong research, but not formally FDA-approved for this indication

• Effectiveness: Rapid relief in treatment-resistant depression and suicidal ideation

• Dosing flexibility: Highly customizable based on patient weight, sensitivity, and history

• Experience: Some patients report dissociation, emotional processing, and deep insight during sessions

• Integration: Often paired with psychotherapy for long-term benefit

🔹 Spravato® (Esketamine Nasal Spray)

• What it is: A more targeted form of ketamine (esketamine — the S-enantiomer), delivered intranasally

• How it's administered: Self-administered under supervision in-office; monitored for 2 hours

• FDA approval: Approved for treatment-resistant depression and major depressive disorder with suicidal thoughts or behaviors

• Insurance coverage: Often covered by insurance with prior authorization

• Dosing: Standardized doses; follows a set protocol (twice weekly initially, then tapered)

• Experience: Milder dissociation than IV for many; some grogginess or dizziness post-dose

• Monitoring: Requires 2 hours of on-site observation per FDA guidelines

🧠 What to Expect During Treatment

For IV Ketamine:

• You'll receive a slow IV drip in a relaxing, private room

• Sessions typically last 60 minutes, followed by brief monitoring

• Some feel dissociation or emotional catharsis — this is normal and part of the therapeutic process

• You'll need someone to drive you home

For Spravato®:

• You self-administer the nasal spray under clinical supervision

• You'll rest and be monitored for 2 hours (required by REMS program)

• You cannot drive for the rest of the day — arrange for a ride

• Most clients do 2 sessions per week for the first month, then taper

🧭 Which One Is Right for You?

Both options can be highly effective. IV ketamine allows for greater flexibility and is often used for clients who prefer a customized approach. Spravato® may be ideal if you prefer a standardized treatment protocol and want to use insurance.

We’ll work with you to determine the best treatment option based on your goals, medical history, and response to prior interventions.

Integrated Approach at SOKA Wellness

At SOKA, ketamine is never a stand-alone solution. We incorporate:

• Clinical monitoring in a supportive setting

• Psychotherapeutic integration after sessions

• A focus on long-term stability, not just short-term relief