Dr. Ben Yudkoff, Co-Founder and Chief Medical Officer at Lumin Health, hosted a Reddit AMA on r/TherapeuticKetamine community on March 6th, 2026\. The below blog post is a recap of one of the questions presented on that AMA, syndicated to the Lumin Health blog in the event that it answers any questions about ketamine therapy, Spravato treatment, or general concerns you may have about treatment.
[https://www.reddit.com/r/TherapeuticKetamine/comments/1rj2blv/ama\_im\_dr\_ben\_yudkoff\_psychiatrist\_cofounder/](https://www.reddit.com/r/TherapeuticKetamine/comments/1rj2blv/ama_im_dr_ben_yudkoff_psychiatrist_cofounder/)
Don’t hesitate to get in touch with us if you’re interested in learning more about ketamine for depression at Lumin Health. Thank you once again to the moderators and community members for facilitating such an engaging discussion.
LizzyP25 asks:
Is there a difference between spravato and ketamine
Answer from Dr. Ben Yudkoff, Co-Founder and Chief Medical Officer of Lumin Health:
Great question\! Ketamine is the parent compound that consists of two molecules that are identical but for their orientation, much like your image in the mirror is you but seen in reverse. Ketamine consists of a right-sided oriented molecule, called “r-ketamine” and a left-sided oriented molecule called “s-ketamine.” The s-ketamine (which is esketamine, or Spravato) is the significantly more active orientation of the molecule and, unlike the r-ketamine, can be absorbed through mucosa (the pink skin that lines the nose and mouth). Spravato (aka esketamine) has an FDA approval for the treatment of treatment refractory MDD and MDD with suicidal thoughts. Ketamine is used entirely off label and has an evidence based for treatment MDD, depression associated with bipolar disorder, OCD, PTSD, and anxiety. Ketamine is usually given as an IV infusion or intramuscular injection, but can also be compounded and provided as a lozenge or a nasal spray – one of the differentiating factors between ketamine as a nasal spray and esketamine (Spravato) as a nasal spray has to do with the total volume of spray needing to be delivered – the more spray delivered (which would be necessary with ketamine) the less likely that the entire dose will be absorbed. Ketamine delivered IV or IM seems to be more effective than Spravato, potentially owed to the ability to utilize a greater dose range with ketamine than Spravato, although Spravato remains pretty effective.
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