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Ketamine vs Esketamine

Ketamine and esketamine are often discussed together because both are rapid-acting treatments used in depression care, but they are not the same thing.

The most important difference for patients is regulatory status: FDA’s depression guide lists esketamine as an approved NMDA antagonist delivered through the restricted Spravato REMS program, while ketamine infusion is typically discussed in practice as an off-label treatment model rather than a standard FDA-approved depression drug.

Comparison points

Regulatory status

• Esketamine: FDA-approved for specified depression use in a restricted REMS program.

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