Oral Ketamine vs. Intravenous vs. Nasal Ketamine: Let's Compare the Three

When it comes to ketamine, you probably find yourself thinking, "Isn't that the stuff they use in surgery?" Yes, but there is more to it. It is a powerful treatment for many mental health issues, such as depression and anxiety. It gets even more interesting when you learn that there are three ways of taking it: oral, IV, and nasal.

But here's the million-dollar question: what kind of ketamine is the best? Should you go with the ease and convenience of a pill, the immediacy of an IV, or is there a happy medium in the form of a nasal spray? Don't worry, as we will discuss the science of ketamine administration.

Read ahead to learn which method is worth your time and money.

Overview of Ketamine Treatments

Ketamine isn't just an anesthetic anymore. It has grown to address mental conditions like treatment-resistant depression, anxiety, and PTSD. As a matter of fact, ketamine provides rapid relief when medicines take weeks to show results.

However, when it comes to ketamine, you have different options. You can take ketamine orally, usually in tablet or lozenge form, through an IV infusion, or via nasal spray. Each has its pros and cons, and knowing which one is right for you can make all the difference.

Oral Ketamine

Oral ketamine is one of the more convenient forms of ketamine therapy, usually administered in pill or lozenge form. This method is usually prescribed when long-term management is required and for people who would like to avoid more invasive treatments like IV infusions.

The convenience comes at a price: oral ketamine is widely regarded as the least effective form of administration because of its low bioavailability.

Basically, bioavailability refers to the amount of drug that finally reaches the bloodstream after having been ingested. The bioavailability of oral ketamine is only about 17-25% absorbed, which is considerably less compared to other forms of administration, such as IV or nasal.

Advantages

1. Non-invasive
2. Oral ketamine is generally more affordable

Disadvantages

1. Slower onset
2. Less precise dosing
3. Limited effectiveness

IV Ketamine

IV ketamine is still a gold standard of unparalleled potency, precision, and speed of action. Since the route of administration of IV ketamine is taken directly into the bloodstream, this way provides 100% bioavailability. It means that the human body absorbs the complete dose right away. And this is exactly what patients in a crisis need.

Advantages

1. Rapid onset of action
2. Precise dosing
3. Effective in treatment-resistant mental health conditions

Disadvantages

1. Requirement of the clinical setting
2. Higher cost

Nasal Ketamine

Nasal ketamine, a method of administration more often provided with esketamine (the derivative of ketamine), represents something of a middle ground between the ease of oral ketamine and potency, found in the IV treatments.

In 2019, the FDA approved the use of nasal ketamine under the brand name Spravato. Since then, it has become relatively popular as a treatment for depression, especially for those patients with histories of failing to respond to traditional forms of antidepressants.

It is more bioavailable than oral ketamine, with absorption through the nasal mucosa of about 45-50%. Though not as immediate as IV, nasal ketamine usually starts working within 30-60 minutes; thus, it offers faster relief compared with oral forms. This makes it ideal for those people who would not like invasive treatment yet need quicker results than what oral ketamine can provide.

Advantages

1. Non-invasive
2. Faster-acting than oral ketamine
3. Moderate bioavailability

Disadvantages

1. Less predictable absorption
2. Multiple doses required
3. Potential for nasal irritation

Comparison: Ketamine IV vs Oral vs Nasal

When it comes down to a decision on ketamine IV, oral, and nasal, a number of characteristics come into play, such as effectiveness, onset of action, convenience, and cost. Each has its pros and cons, and the decision is pretty much left to individual needs and the severity of the conditions.

Below is a comparison of the three methods.

Ketamine IV is the most potent: effective, fast-acting, and fairly accurate with regard to dosage. Yet, it requires more frequent visits to a clinic and generally is the most expensive option. This, therefore, makes it ideal for acute cases-such as treatment-resistant depression-where the intervention needs to be swift.

Oral ketamine is convenient and the least expensive. Yet, it has the lowest bioavailability and, hence, is not that effective for immediate relief in patients.

Nasal ketamine strikes a balance between these. It is less invasive than IV, faster-acting than oral, and very effective for moderate symptoms. For those who would like to be somewhere in the middle concerning convenience and effectiveness, the nasal way is usually their choice.

The decision on IV vs. oral vs. nasal ketamine should be made by a professional who can individualize treatment based on your needs.

Which is Best for You?

Ultimately, the choice between oral, IV, and nasal ketamine depends on many variables, including personal needs, severity of symptoms, and pragmatic considerations like cost and convenience.

The "best" method of the treatment option ultimately concerns your health goals and lifestyle. A healthcare professional offering ketamine treatment in a Long Island clinic, like Ketalink, can help you make such decisions and ensure you get the best form of treatment for your situation.

If you're considering ketamine treatment and want to know more about your options, then contact us at Ketalink for professional guidance.