Routes of Ketamine Administration

What many people don’t realize is that it’s quite common for antidepressants to not provide the relief you need. In fact, 30% of depression patients do not respond to traditional antidepressants. In the medical field, we call this treatment-resistant depression. Luckily, ketamine and esketamine (branded as Spravato) are two medication options that affect the brain differently with an impressive 75% success rate in patients who have tried four or more traditional antidepressants. We can compare this to the 10% success rate these patients are expected to have if they were to try another antidepressant medication.

Ketamine is fast-acting and may help patients begin feeling better within hours of their first treatment.

When considering whether ketamine is right for you, it’s important to consider the three most common routes of ketamine administration, including intranasal, intravenous infusions, or intramuscular injections. At Manlove Brain and Body Health in Rapid City, we offer each of these routes of ketamine administration which allows you and your provider the flexibility to choose which works best for you. Below, we have outlined some of the major differences to help you understand your options.

Ketamine IV Infusion

When ketamine is given intravenously through an IV. When patients choose this particular route, they will absorb much higher levels of the medication (roughly 99%) compared to intranasal infusions. Since the medication is directly inserted into the bloodstream, some patients may experience a sudden lift of their depression after just one dose.

During an IV infusion, ketamine is administered at a steady rate over roughly 40 minutes. IV infusions give the greatest amount of flexibility which can help reduce your side effects. Your provider will initially set your dosage and rate of administration based on your weight, and during the course of your treatment session, your provider will be able to make adjustments based on any side effects you may experience.

While the exact number of ketamine infusions you receive will depend on your unique case, we typically begin with six infusions over 2-3 weeks. After the first two weeks, doses may be spaced out a few weeks apart. Many patients require maintenance treatments at a reduced frequency. Maintenance treatments may be given weekly, monthly, or less. Typically, maintenance treatments are given every 4-6 weeks to start and taper off overtime.

This route of infusion has been the most studied in the medical community and is the most commonly chosen option among our patients.

Ketamine Shot

Ketamine may be administered intramuscularly through an injection in the arm. Treatments are quick but may require multiple injections for a single treatment session. Roughly 93% of the medication is absorbed when administered through an injection.
Compared to an IV infusion, there is less control over the dosage. However, the dosage may still be adjusted in subsequent treatment sessions based on your response and side effects.

Intramuscular injections follow a similar cadence to IV infusions. You can expect to receive six injections over the first 2-3 weeks, followed by one injection every few weeks as needed.

Ketamine Nasal Spray

Both ketamine and esketamine (Spravato) are offered intranasally as a nasal spray and are offered in two strengths. When administered intranasally, roughly 20-30% of the medication is absorbed, so more frequent treatments are required to have the same effect as intramuscular or intravenous infusions.

Typically, you will receive two treatments per week for the first four weeks, followed by one treatment a week for an additional five weeks.

Work with a Psychiatrist

There are a lot of clinics that specialize in ketamine. Specializing in a particular drug, versus a medical discipline (such as mental health or cardiology) is a relatively new and concerning development. For example, many of our patients have other psychiatric problems that also need to be treated while they receive ketamine. Our providers will also be able to advise you on whether ketamine could worsen any other mental health conditions you may have.

Call today to schedule an introductory appointment. Our mental healthcare professionals will be happy to sit down with you to discuss if ketamine is right for you.