[Den-vr]

The nasal spray? An anesthesiologist told me that it's 1/10th as effective as IV therapy due to some aspect of bioavailability and how it ultimately didn't produce the same sort of norketamine levels required.

edit: For context, he subsequently complained of how big pharma was conspiring to destroy ketamine iv therapy access in order to better control the "legal ketamine" market.

[GordonS]

IV is not 10x more effective than intranasal - it's maybe twice as effective.

IV bioavailability is 100%, intramuscular 93%, intranasal around 50%, and oral around 20%.

This is something I just don't understand about IV ketamine therapy - IV protocols vary wildly, and I haven't been able to find any reasons why IV would be more effective than any other route of administration with an increased dose.