The Differences Between Nasal, Intravenous, Intramuscular and Oral Ketamine Treatments

Over the last 20 years, research on the effectiveness of ketamine in treating mood disorders has dramatically changed the way the medication is used. This has led to the development of different forms of ketamine that are administered in different ways. Today, patients are no longer tied to an IV if they want to benefit from ketamine therapy.  

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Ketamine treatments now come in four forms: oral, nasal, intravenous and intramuscular. 

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How Different Forms of Ketamine Are Administered 

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Each type of ketamine is given in a different way, which affects the convenience, effectiveness and cost. A qualified physician can help a patient determine what type of ketamine treatment will work best. 

It’s worth noting that even though patients can realistically take oral and nasal ketamine on their own, it must be done under medical supervision. Choose Ketamine has developed a novel program that allows patients to take oral ketamine at home while still having your medical team at your side. 

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Oral Ketamine

Oral ketamine, also known as sublingual ketamine, is taken by mouth. It’s most commonly in a tablet form. The ketamine tablet is held under the tongue so that it melts and is readily absorbed. After about 10 minutes the remaining medication is spit out. This method has been proven to be safe and effective when administered by the patient under the supervision of a medical professional. 

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Nasal Ketamine

A form of ketamine known as esketamine is a nasal spray that’s administered in the nose just like nasal decongestants. While this method is convenient, variations in nasal absorption rates and inconsistency in dosing sprays make esketamine less effective consistent compared to IV and oral ketamine. 

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Intravenous Ketamine (IV)

IV Ketamine is a solution that’s administered directly into the bloodstream by infusion. This means that a needle or catheter with a solution of ketamine is injected into the patient’s veins. This type of ketamine therapy must be done in a medical treatment facility under direct supervision. 

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Intramuscular Ketamine

Intramuscular ketamine delivery is the least common of the four because this method has a lower absorption rate and isn’t as easy to control. It’s administered in the same way vaccinations are given. The ketamine is a solution that’s injected into the muscles of either the arm or the leg. 

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The Effectiveness of Different Forms of Ketamine

Research has revealed that some forms of ketamine are more effective than others. This is primarily due to bioavailability, or how the medication is absorbed by the body.

So far, intravenous ketamine is the gold standard in terms of effectiveness and being able to control dosage. But decades of research has helped give patients more options that are less intrusive and can be just as effective at treating mood disorders.

Oral ketamine is quickly becoming the go-to treatment given its effectiveness, lower cost and convenience for patients. The low risk of side effects also makes oral ketamine the preferred method for many people. 

Nasal ketamine is less effective and takes longer to generate results but is still shown to work well in some patients. The nasal ketamine medication Spravato was FDA-approved in 2019 for the treatment of depression. As noted above, intramuscular ketamine could be less effective due to lower absorption rates in the bloodstream and the inability for continuous control. 

Oral, Nasal, Intramuscular and IV Ketamine Costs

Another differentiator between oral, IV, intramuscular and nasal ketamine is the cost. The type of ketamine therapy is going to impact the cost of treatment. Where you’re at in the treatment process also matters. The first month of ketamine therapy, when multiple doses are most likely needed, the total cost can be as little as $400 all the way up to $5,000 depending on the type of ketamine treatment that is administered. The following months when only one or two treatments are needed the monthly cost is typically $200-$1,600.

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Oral Ketamine Costs

The most cost effective option is oral ketamine. It can be as little as $150-200 per supervised treatment. On average it’s at least 60% less expensive than IV ketamine treatments.

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Nasal Ketamine Costs

Spravato is a good benchmark for nasal ketamine costs. This form of ketamine is sold as a bottle containing multiple treatments. The cost can range from $4,700-$6,800 in the first month depending on the dosages. After that it’s usually somewhere between $2,300-$3,500 a month. It works out to be around $350+ per spray. 

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Intravenous Ketamine Costs

IV ketamine costs tend to range from $400-$1,000 per infusion. This is the most expensive ketamine treatment in terms of cost per treatment. 

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Intramuscular Ketamine Costs

One of the benefits of intramuscular ketamine compared to intravenous ketamine is the cost. Ketamine injections are typically 30-40% less than infusions. You can expect to pay $250-$700 per injection, but you may need more injections than infusions each month. 

Certain forms of ketamine are both affordable and convenient because they can be used at home. Take the Choose Ketamine assessment to find out more about oral ketamine treatments and if they’re right for you.  

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