IV Ketamine vs Esketamine: What’s the Best Ketamine Treatment for Depression?

If you’re researching the best ketamine treatment for depression, you’ve likely come across two options: intravenous (IV) ketamine and intranasal esketamine (Spravato®). While both are used for treatment-resistant depression, recent research shows that IV ketamine offers superior results.

A 2021 meta-analysis published in the Journal of Affective Disorders compared IV ketamine to intranasal esketamine across 24 clinical trials. IV ketamine showed significantly higher rates of response and remission. Patients were more than twice as likely to get better—and almost three times as likely to achieve full remission—compared to those treated with esketamine. IV ketamine also had fewer treatment dropouts due to side effects (Bahji et al., 2021).

Durability matters too. A 2025 observational study in the Journal of Clinical Psychiatry found that patients receiving IV ketamine could go almost twice as long between treatments—about 19 days versus 11 with esketamine (Singh et al., 2025). That means fewer clinic visits, lower costs, and more time living your life.

At Innate Ketamine Therapy, we specialize in IV ketamine infusions because the evidence consistently supports its effectiveness, safety, and long-lasting results.

Looking for the most effective ketamine treatment for depression? IV ketamine may be your best option.

Sources: Bahji et al., J Affect Disord 2021; Singh et al., J Clin Psychiatry 2025.