When Pills Don’t Work, You Deserve Better Options
Depression doesn’t always look like sadness. For some, it’s hiding in bed for hours. For others, it’s smiling in public while breaking down in private. No matter how it shows up, depression can take over your life. And sadly, for millions of people, antidepressants simply don’t help.
In places like Phoenix, Gilbert, Glendale, and beyond, patients are turning to newer and faster-acting options—like ketamine therapy and Transcranial Magnetic Stimulation (TMS)—because traditional treatments just aren’t enough.
This post covers the most current, proven types of ketamine treatment for depression, including ketamine infusion vs Spravato®, oral ketamine, intramuscular injections, and ketamine-assisted psychotherapy (KAP). You’ll learn how each one works, how fast they can help, and how they compare to antidepressants.
“Mental illness is nothing to be ashamed of, but stigma and bias shame us all.”
— President Bill Clinton
Right now, over 30% of people with depression don’t get better with traditional medication. And many don’t get any real relief until they’ve tried three or four pills over several months or years. That wait is dangerous. Depression increases the risk of suicide, job loss, and long-term health problems.
You don’t have to wait anymore. There are faster, safer options.
What Is Ketamine and Why Is It Used for Depression?
Originally developed as a surgical anesthetic, ketamine has become one of the most exciting breakthroughs in mental health care. Instead of targeting serotonin like most antidepressants, ketamine works on glutamate, which helps reset and rebuild the brain’s mood centers.
Unlike standard antidepressants, ketamine often brings relief within hours to days, not weeks. That speed matters—especially for people in crisis.
Doctors and clinics now use multiple forms of ketamine therapy to treat depression. Each has unique benefits, side effects, and insurance coverage levels.
The 5 Main Types of Ketamine Treatment for Depression
1. IV Ketamine Infusion Therapy
This is the original and most researched form. Ketamine is delivered into your bloodstream through an IV line while you sit in a comfortable clinical setting.
- Sessions usually last about 40 to 60 minutes
- Patients often complete 6 to 8 infusions over 2 to 4 weeks
- Relief is sometimes felt after just one or two sessions
- Currently used off-label (not FDA-approved for depression)
- Insurance usually does not cover it
IV infusion is best for those who need quick relief and are willing to pay out-of-pocket or use a financing plan.
2. Intramuscular (IM) Ketamine Injections
Instead of using an IV, this method injects ketamine directly into the muscle—usually in the shoulder or thigh.
- Faster and less invasive than IV
- Also used off-label
- Supervised by trained medical staff
- Can bring rapid symptom relief
- Typically not covered by insurance
This method is often chosen for its ease and cost-effectiveness compared to infusions.
3. Spravato® (Esketamine Nasal Spray)
Spravato® is a form of ketamine that’s been FDA-approved for adults with treatment-resistant depression and major depression with suicidal thoughts. It’s taken through a nasal spray under medical supervision.
- Only offered at REMS-certified clinics like Bella Vida TMS
- Covered by most major insurance providers
- Can bring fast symptom relief within 24 to 48 hours
- Administered in-office 2 times a week to start, then less often
- You must remain onsite for 2 hours of monitoring after each dose
Spravato® is ideal for people who want the power of ketamine but need the reassurance of FDA approval and insurance support.
4. Oral Ketamine (Lozenges or Capsules)
Oral ketamine is often used in follow-up or maintenance care after IV or IM treatments.
- Taken at home under a doctor’s guidance
- May be used alongside therapy
- Effects are slower and less intense
- Off-label and rarely covered by insurance
- Requires strict adherence to safety plans
This is best for patients who already responded to other forms and want a more flexible, long-term option.
5. Ketamine-Assisted Psychotherapy (KAP)
This combines ketamine treatment—usually oral or IM—with structured talk therapy. You meet with a trained mental health professional to prepare, experience, and process each ketamine session.
- Sessions last 1.5 to 3 hours
- Designed to help patients access emotions and resolve trauma
- Gaining popularity for those with PTSD or emotional blocks
- Can involve deep reflection and spiritual or emotional breakthroughs
- Usually self-pay, not covered by insurance
KAP is ideal for people seeking not just symptom relief but deep psychological transformation.
Ketamine Infusion vs Spravato®: What’s the Real Difference?
The biggest differences between ketamine infusion and Spravato® are approval status, delivery method, and insurance coverage.
Ketamine Infusions:
- Delivered through IV
- Not FDA-approved for depression (off-label use)
- Typically not covered by insurance
- Requires visits to a ketamine clinic
- Rapid results, sometimes within hours
Spravato®:
- Delivered through a nasal spray
- FDA-approved for treatment-resistant depression
- Covered by most insurance plans
- Administered in a certified medical setting
- Similar fast results, often after 1–2 sessions
If you’re trying to decide between the two, your medical history, insurance status, and comfort level with each method will help determine the right path.
How Does Ketamine Compare to Antidepressants?
Antidepressants work for many—but not all. They increase serotonin or norepinephrine in the brain, which can help with mood. But they take 6 to 8 weeks to fully kick in, and more than 30% of patients never get full relief.
Ketamine, on the other hand:
- Works in hours to days, not weeks
- Bypasses traditional serotonin pathways
- Often helps people who have failed 2–3 or more antidepressants
- Can reduce suicidal thinking quickly
- Offers relief without the daily pill routine
Some patients do best using both—starting with ketamine to feel better fast, then using medication or therapy to maintain results.
What About TMS?
While ketamine is powerful, some people want a non-drug option. That’s where Transcranial Magnetic Stimulation (TMS) comes in.
TMS uses magnetic pulses to stimulate the part of your brain that regulates mood. It’s:
- FDA-approved
- Non-invasive and drug-free
- Covered by most insurance providers
- Done in-office, with sessions lasting 18–30 minutes
- Has few side effects and no memory or sedation issues
TMS is often recommended if you’ve had side effects from antidepressants or don’t want to use medication at all. At Bella Vida TMS, we provide both TMS and Spravato®, helping you choose the path that’s best for you.
Who’s a Good Candidate for Ketamine?
You may be a candidate for ketamine therapy if you:
- Have major depressive disorder
- Have tried two or more antidepressants without relief
- Are experiencing thoughts of self-harm or hopelessness
- Want to avoid long-term daily medications
- Have tried therapy but need deeper or faster relief
Many patients who walk into Bella Vida TMS feeling like they’ve “tried everything” are amazed to learn they still have powerful options—backed by science and compassion.
Are There Risks?
Yes, like any treatment, ketamine has risks. It’s important to know:
- Common side effects include dizziness, nausea, and temporary dissociation
- You shouldn’t drive or operate machinery the day of your treatment
- People with uncontrolled blood pressure or certain psychiatric conditions may not be eligible
- Ketamine should only be taken under medical supervision—not at home without a plan
We take every precaution at Bella Vida TMS to ensure your safety.
Start Here. Start Healing.
Depression may feel endless—but it doesn’t have to be. With today’s treatments, you don’t have to wait months for relief. Whether it’s IV infusion, Spravato®, oral lozenges, or TMS, help is out there—and it works.
At Bella Vida TMS, we help patients across Phoenix, Scottsdale, Gilbert, and Glendale find the right fit based on their symptoms, budget, and personal goals.
FAQ’s
The most effective type varies by person, but IV ketamine infusions and Spravato® (esketamine) are the most widely used and studied. IV infusions may offer fast symptom relief, while Spravato® is FDA-approved and covered by most insurance. Your best option depends on your medical history, treatment goals, and insurance coverage.
Yes, when administered by trained professionals, ketamine therapy is generally safe. Common side effects include dizziness, nausea, and temporary dissociation. It should only be used under medical supervision, especially for people with high blood pressure or certain psychiatric conditions.
Ketamine infusions deliver the drug through an IV and are used off-label for depression. Spravato® is a nasal spray form of esketamine, FDA-approved for treatment-resistant depression and administered in a certified clinic. Spravato® is more likely to be covered by insurance.
Many people experience relief within a few hours to days after their first or second session. This is much faster than traditional antidepressants, which may take 6–8 weeks to work.
Yes, Bella Vida TMS accepts most major insurance plans, including those that cover Spravato® and TMS therapy. IV and IM ketamine may not be covered, but our team can verify your benefits and help you understand your options.
References:
- National Institute of Mental Health (NIMH) – Depression: Overview
https://www.nimh.nih.gov/health/topics/depression - American Psychiatric Association – What Is Depression?
https://www.psychiatry.org/patients-families/depression/what-is-depression - Yale School of Medicine – Ketamine for Depression
https://medicine.yale.edu/news-article/ketamine-offers-hope-for-people-with-severe-depression/ - Harvard Health Publishing – Ketamine for major depression: New tool, new questions
https://www.health.harvard.edu/blog/ketamine-for-major-depression-new-tool-new-questions-2019052216673 - FDA (U.S. Food & Drug Administration) – FDA Approves New Nasal Spray Medication for Treatment-Resistant Depression
https://www.fda.gov/news-events/press-announcements/fda-approves-new-nasal-spray-medication-treatment-resistant-depression - Journal of Affective Disorders – Rapid antidepressant effects of ketamine in major depression
https://www.sciencedirect.com/science/article/abs/pii/S0165032711001562 - Spravato® Official Website – Indications and Safety Information
https://www.spravato.com - Stanford Medicine – Ketamine Therapy Overview
https://med.stanford.edu/psychiatry/patient_care/ketamine.html - National Library of Medicine (PubMed) – Comparative Efficacy of Ketamine and TMS in Depression
https://pubmed.ncbi.nlm.nih.gov/ - Brain & Behavior Research Foundation – TMS for Treatment-Resistant Depression
https://www.bbrfoundation.org/content/tms-treatment-resistant-depression
