Spravato Clinics Australia

As Australia continues to explore innovative treatments for treatment-resistant depression (TRD) and other mental health conditions, esketamine has emerged as a promising therapy. Delivered via nasal spray under the brand name Spravato®, esketamine is available at select approved clinics nationwide. However, due to regulatory controls, costs, and access limitations, many patients and clinicians are considering ketamine infusions or psychedelics such as psilocybin or empathogen MDMA as a more affordable and accessible alternative.

This article explores how esketamine clinics operate in Australia, the current landscape for patients seeking this treatment, and the emerging case for ketamine as a cost-effective alternative.

What Is Esketamine and How Is It Used in Australia?

Esketamine is a chemical mirror image (enantiomer) of ketamine, designed for intranasal use. Unlike traditional antidepressants that target serotonin or dopamine, esketamine works through the glutamate system, promoting neuroplasticity and providing rapid symptom relief—often within hours or days.

In Australia, esketamine (Spravato®):

• Is approved by the TGA (Therapeutic Goods Administration) for treatment-resistant depression in combination with oral antidepressants.
• Must be administered in a clinical setting due to the potential for dissociation, sedation, and blood pressure changes.
• Requires 2–3 sessions per week during the initial treatment phase, tapering to less frequent maintenance doses.

Treatment can only be administered at certified Spravato clinics with trained healthcare professionals on-site for at least two hours of post-dose monitoring.

The Cost Barrier of Esketamine Clinics

One of the biggest challenges facing patients is the high cost of esketamine therapy in Australia:

• A single session can cost between $700–$1,200 AUD, including monitoring fees.
• A full 6-8 week course may cost upwards of $8,000–$12,000 AUD.
• Spravato is not currently subsidised by the Pharmaceutical Benefits Scheme (PBS), meaning all costs are out-of-pocket.

Even with private health coverage, many patients find the cost prohibitive, especially when ongoing maintenance is required.

Ketamine Infusions: A More Accessible Option

In contrast, racemic ketamine—a mixture of two mirror-image molecules, including esketamine—is increasingly being used off-label in Australia for depression, PTSD, and chronic pain. Ketamine infusions:

• Are typically delivered intravenously (IV) or intramuscularly (IM) in specialist mental health or anaesthetic clinics.
• Have demonstrated comparable efficacy to esketamine in clinical research for depression and suicidal ideation.
• Cost between $300–$600 per session, depending on the clinic and location—often half the price of esketamine.

Although not formally approved by the TGA for mental health use, ketamine treatment is legal when prescribed by qualified practitioners under strict clinical protocols.

Comparing Esketamine and Ketamine

Barriers and Ethical Considerations

While ketamine may offer a more affordable path for many patients, it also presents challenges:

• Off-label use means more variability in protocols, dosing, and monitoring.
• Lack of long-term data compared to conventional antidepressants.
• Risk of recreational misuse or dependence without proper clinical supervision.

Still, for those who cannot afford esketamine or access a certified clinic, ketamine may be the only realistic option for relief from debilitating depression.

Conclusion

Esketamine represents a breakthrough in depression treatment, but its high cost and limited availability in Australia can put it out of reach for many patients. Ketamine infusions, though used off-label, offer a clinically sound and more accessible alternative when delivered responsibly.

As public awareness grows and the stigma around psychedelic therapies continues to shift, it’s likely that both esketamine and ketamine will play increasing roles in Australia’s mental health landscape—particularly if cost and access barriers are addressed.

If you would like us to help you find the right type of treatment, get in contact with one of our healthcare professionals using this form or join a public discussion group such as The Transparent Company.