If you have been researching treatments for treatment-resistant depression (TRD), you have almost certainly come across two names: Spravato® (esketamine) and ketamine therapy. Both are remarkable advances in psychiatry. Both target the brain’s glutamate system — a fundamentally different approach from traditional antidepressants. And both are available at Ventana Mental Health’s Southlake, TX clinic.

But they are not the same. The right choice depends on your diagnosis, insurance, medical history, and treatment goals. This guide gives you a clear, honest comparison so you can have an informed conversation with your psychiatrist.

What Is Spravato® (Esketamine)?

Spravato® is the brand name for esketamine — a nasal spray formulation of a ketamine derivative manufactured by Janssen Pharmaceuticals. In 2019, the FDA approved Spravato as the first new mechanism-of-action antidepressant in over 30 years. It holds approval for:

• Treatment-Resistant Depression (TRD) — adults who have failed at least two antidepressants
• Major Depressive Disorder with Acute Suicidal Ideation or Behavior (MDSI)

Because Spravato carries FDA approval and is part of a REMS (Risk Evaluation and Mitigation Strategy) safety program, it is covered by most major insurance plans — making it financially accessible for many patients.

At Ventana Mental Health, Spravato is administered in-clinic under direct medical supervision. You self-administer the nasal spray while our team monitors you for at least two hours following treatment.

What Is Ketamine Therapy?

Ketamine has been used as an FDA-approved anesthetic since the 1970s. Its use for depression is considered off-label — meaning it is not FDA-approved for psychiatric conditions, but extensive clinical research and real-world evidence support its effectiveness.

According to the National Institute of Mental Health (NIMH), ketamine produces rapid antidepressant effects — often within hours — which is why it has become a crucial option for those with severe or treatment-resistant symptoms.

At Ventana Mental Health, we offer sublingual ketamine — administered under the tongue — starting at $250 per session. Sessions are supervised by our board-certified psychiatrists in our Southlake clinic.

Spravato vs. Ketamine: Side-by-Side Comparison

Feature	Spravato® (Esketamine)	Ketamine Therapy
FDA Approval	✅ FDA-approved for TRD & MDSI	⚠️ Off-label use for depression
Insurance Coverage	✅ Most major plans; copays from $10	❌ Typically not covered (out-of-pocket)
Administration	Nasal spray (self-administered in clinic)	Sublingual (under the tongue)
Session Length	~2.5 hours (includes monitoring)	~45–60 min + brief monitoring
Cost at Ventana	As low as $10 copay (insurance)	From $250 per session
Speed of Effect	Hours to days	Hours to days
Best For	TRD with insurance coverage; MDSI	TRD, anxiety, PTSD, OCD; uninsured
Approved Indications	TRD, MDD with suicidal ideation	Depression, anxiety, PTSD, OCD (off-label)
Available at Ventana	✅ Southlake clinic	✅ Southlake clinic

Insurance & Cost: The Practical Reality

For many patients, cost is the deciding factor. Here is how the two treatments differ:

Spravato® Insurance Coverage

Because Spravato is FDA-approved, most major insurance plans — including Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna, Humana, and many others — cover it when patients meet TRD criteria. At Ventana Mental Health, our team verifies your insurance before treatment begins, so there are no surprises. Eligible patients often pay as little as $10 per session.

Ketamine Therapy Cost

Ketamine used off-label for depression is not covered by insurance at most clinics. At Ventana Mental Health, sublingual ketamine sessions start at $250 per visit — among the most affordable pricing in the Dallas–Fort Worth area. A standard initial protocol of 6 sessions runs approximately $1,500 before any payment plans.

Who Qualifies for Each Treatment?

Both Treatments Available at Ventana Mental Health — Southlake, TX

At Ventana Mental Health, you do not have to choose before you know your options. Our board-certified psychiatrists will conduct a comprehensive evaluation and recommend the most appropriate treatment based on your:

• Medical and psychiatric history
• Insurance coverage and financial situation
• Current medications and treatment history
• Specific diagnosis and symptom severity

We offer both Spravato® and sublingual ketamine at our Southlake clinic, serving patients from across Dallas, Fort Worth, Grapevine, Colleyville, Keller, Trophy Club, Flower Mound, and the entire DFW metroplex. We also offer telepsychiatry throughout Texas for initial consultations and follow-up care.

For more detailed information on each treatment, visit our dedicated pages:
→ Spravato® Treatment at Ventana
→ Ketamine Therapy at Ventana

Frequently Asked Questions