Two patients can walk into a ketamine clinic on the same day, hear the word “ketamine,” and receive two very different treatments. One receives a nasal spray that most insurance plans cover. The other receives an IV treatment built around a dose chosen just for them. Both are physician-supervised, both can bring relief, and both work best when something else happens alongside them: psychotherapy.
If you are comparing options, that can feel like a lot to untangle. We want to make it simpler. At Renew Ketamine Infusion, we offer both IV ketamine and Spravato at our San Juan Capistrano, Seal Beach, and Tustin locations, and we combine each with integrative psychotherapy. In this guide, we explain how the two treatments differ and how ketamine-assisted psychotherapy works, so you can walk into your first conversation with us knowing what to ask.
What Is the Difference Between IV Ketamine and Spravato?
Let’s start with the short version. Ketamine is a medicine that was FDA approved in 1970 and is used widely, every day, for pain control and analgesia for its safety profile. Spravato is esketamine, a version of the medicine that is FDA approved for the treatment of depression. IV ketamine, by contrast, is considered off-label for depression.
Off-label sounds like a warning, but it is a routine part of medicine. It means using an approved medication for a purpose that was not part of its original FDA application. Many medications are used off-label every day. In ketamine’s case, extensive evidence now supports its effectiveness and safety, but new FDA trials are very unlikely because the drug is generic and no longer a brand drug.
Here is how the two treatments compare in practice.
How the Medicine Is Delivered
With IV ketamine, you receive your medicine through a small IV in your arm, placed by one of our expert nurses. The dose runs over 40 minutes. With Spravato, you receive the medicine as a nasal spray. Based on research, we consider these routes the most bioavailable, customizable, and effective ways to administer ketamine.
How the Dose Is Decided
This is where IV ketamine stands out. We do not believe in a model where everyone receives the same dose and the same number of sessions. Our physicians create an individualized treatment plan for you. Everyone responds differently, so the dose, the session length, and the number of sessions are shaped around your needs. For mood and pain, session duration can vary from 40 minutes to 4 hours. You can also pause or stop a session immediately if you need to. That rarely, if ever, has to happen, but we want you to know the option is always there.
If you need extra comfort during a session, we can add medication for symptom control, such as Zofran for nausea, Benadryl for an allergic reaction, or Versed for anxiety.
Spravato follows a regimented FDA treatment guide, so the structure of your plan is set by that guide rather than built session by session.
How Long Each Visit Lasts
Plan on about 1.5 to 2 hours for an IV ketamine visit. A Spravato visit runs about 2 to 2.5 hours. In both cases, you stay in our clinic under close observation, and you need a ride home afterward. Ketamine can leave you tired and can affect your judgment and your ability to drive for the rest of the day.
How Often You Come In
For IV ketamine, treatment is typically 2 sessions a week for 3 weeks. For Spravato, we follow the FDA schedule, and our team will walk you through it on your free exploration call.
What It Costs and Whether Insurance Pays
Cost is often the deciding factor, and the two treatments are very different here.
- Spravato: Most insurance plans cover it, and we are in network. Most patients pay as little as $10 a treatment.
- IV ketamine: Pricing depends on the length of the session and the number of sessions we recommend. Insurance does not cover IV ketamine, though we offer hybrid insurance billing options. Through our partner platform, Osmind, we can also provide a superbill for insurance claims.
Because plans vary, we cannot promise what your carrier will do. A free exploration call is the quickest way to get a clear answer for your situation.
What Stays the Same
Some things do not change no matter which treatment you choose:
- Physician oversight. Every treatment plan is overseen by our Board Certified medical directors.
- Screening. We screen for medical issues, such as vitamin and thyroid problems, that can mimic depression before prescribing.
- Safety exclusions. People with uncontrolled blood pressure or cardiovascular disease, active substance abuse where withdrawal could be deadly, a history of brain bleed, aneurysm, or arteriovenous malformation, psychosis, active mania, delusions, or hallucinations, acute suicidal ideation, an allergy to ketamine, or untreated thyroid disease or glaucoma should not receive ketamine treatment.
- Side effects. Ketamine is well tolerated, but you may notice nausea, impaired coordination, dissociation, or confusion.
- Integrated psychotherapy. We pair either treatment with psychotherapy, which brings us to the second question.
Which One Is Right for You?
The honest answer is that it depends on your diagnosis, your medical history, your goals, and your coverage. Spravato’s FDA approval is for depression, and insurance coverage can make it very affordable. IV ketamine gives our physicians more room to individualize your dose and plan. During your physician consultation, we review all of this with you and recommend a path. You do not need a physician referral to start, and your consultation is included.
How Does Ketamine-Assisted Psychotherapy Work?
Ketamine-assisted psychotherapy combines two things that each help on their own and help more together: ketamine, and structured therapy before and after your session. We feel strongly about this. We believe ketamine is an extremely important tool in the healing process, and that an integrated psychotherapy program is just as important. Unlike many ketamine clinics that might recommend working with a therapist, we require it, and we provide access to true experts in ketamine-assisted psychotherapy.
What Ketamine Does in the Brain
Ketamine is a molecule that works at many receptors throughout the body. One of its main mechanisms is to block NMDA receptors, which activates the glutamate pathway. That creates new proteins that can help repair and reconnect cells. In plain terms, ketamine promotes neuroplasticity, meaning new synapse formation and the repair of existing synapses.
We describe ketamine as a catalyst. It stimulates a person’s innate capacity for psychological healing. That opening is a window of opportunity, and psychotherapy is how you use it.
What Psychotherapy Adds
Psychotherapy gives you a way to process what you experience and build on it. For many people, that leads to new psychological frameworks for understanding both internal and external stimuli. Here is how that plays out across the conditions we treat:
- Depression. There is a significant group of patients who do not get relief from traditional cognitive behavioral therapy. Ketamine, combined with therapists specifically trained in neuroplastic therapies, can lead to deep psychological healing and help people move past learned behavior and past experiences.
- Anxiety. During treatment and the integration process, patients often gain a better understanding of their anxiety and learn to reframe the triggers that provoke it. It shows people they have the power to heal from within.
- PTSD. Ketamine allows people to reacquaint themselves with a past trauma from an emotionally neutral perspective. It does not make you forget the trauma. It lets you acknowledge it without being continually re-traumatized by thinking about it.
- OCD. Over the course of treatment, neuroplasticity can change or reduce the intrusive, repetitive thoughts and behaviors that define OCD, especially when paired with our integration process.
- Chronic pain. Pain is complex. We believe the real potential for relief comes when ketamine is combined with psychotherapy, because therapy lets a person build new ways of processing what they feel.
What the Process Looks Like Step by Step
Before Treatment
You start with a free exploration call, followed by a virtual consultation with one of our physicians. If you decide to proceed, we schedule your sessions. If you are working with one of the therapists we partner with, we coordinate so that your therapy sessions fall close to your ketamine sessions. We also focus on what we call set and setting, which means preparing you with the right mindset before each treatment. We offer an online video and a podcast on how to prepare for your first ketamine treatment.
Optional Preparation Support
You can also sign up for our Personalized Healing Pathways: Foundation Program. This fully optional coaching support helps you prepare for each session, integrate insights afterward, and build sustainable daily habits.
On Treatment Day
You arrive through our private and discreet entrance, so you will not see other patients. Our team greets you, takes your vitals, and answers any last-minute questions. We guide you through meditations to help you move from the outside world into the clinic. Then you relax in a recliner with a personalized eye mask, noise-canceling headphones, and a curated playlist. Our setting is spa-like, tranquil, and private. We are with you the entire time, and you are never alone.
After Your Session
We give you time to make sense of the experience yourself, along with snacks and refreshments if you want them. Then you meet with your psychotherapist, either your own or one we work with, to process what came up. We also provide workbook exercises crafted by our team, regular check-ins with our clinical team, and free weekly Reset Sessions. Those are live, guided practices focused on sharing wins, practicing gratitude, and grounding with meditation and breathwork. Camera and sharing are always optional, and sessions can be private.
Ongoing Support
If you want coaching to continue after your initial series, our optional Momentum Pathway offers ongoing coaching, advanced mindfulness tools, and deeper accountability. We stay responsive by phone and text throughout, so you are not left waiting for answers.
What Results to Expect
Many people notice effects within hours, and those effects can last a month or more. You can usually resume normal activities the next day, although you may feel heightened emotions for a few days. We do not oversell it. Up to 20% of patients can be non-responders, and the evidence for chronic pain is fairly mixed. To track your progress honestly, we encourage mood assessments through Osmind. If treatment is not helping, we work with you to find alternative care. You are never charged up front for sessions, only per session.
Our goal is sustained relief after a set treatment plan. Ketamine is not meant to be taken for the rest of your life, and additional enhancement sessions are available if you need them.
Questions We Hear Often
Can I do ketamine-assisted psychotherapy with my own therapist?
Yes. You can use your own therapist or one of the therapists we work with. If you use ours, we coordinate scheduling so your sessions are close together.
Do I have to take part in therapy?
Yes. Psychotherapy is a required part of our program, because we believe it is what helps the benefits last.
Do I need to stop my medications?
Not usually. Our physician reviews your medications with you and tells you which to hold and which to continue. Most are fine throughout the program.
Is ketamine addictive?
We take addiction and misuse seriously. The existing data does not show evidence of ketamine being addictive, and our staff monitors you throughout treatment.
Your Next Step: Talk With Us
Choosing between IV ketamine and Spravato does not have to happen alone, and it does not have to happen before you have spoken to a person. Our free exploration call covers your treatment options, your eligibility, and your questions. If ketamine looks like a fit, our physicians then walk you through a thorough medical evaluation and an individualized plan. You can see how it all works on our process page.
We see next-day or same-week intakes, and we offer a free physician consultation. You can reach us at (949) 503-1414 or info@renewketamineinfusion.com. We are open Monday to Saturday, 8:00 am to 6:30 pm, or by appointment.
Schedule your free exploration call today, and let us help you find the treatment that fits you.
