Troches (Oral Ketamine) vs. IM (Intramuscular) Ketamine: Understanding the Difference

If you’ve been exploring ketamine therapy as a treatment option, you’ve probably come across terms like “Troches” and “IM Ketamine.” These refer to two different ways ketamine can be administered: orally via a lozenge (troche) or through an intramuscular (IM) injection. While both methods use the same active compound, the experience, effectiveness, and suitability of each can differ significantly. Let’s break it down.

What Are Ketamine Troches?

Ketamine troches are small lozenges designed to dissolve slowly in your mouth. This method is often used for at-home treatments because it’s convenient and usually doesn’t require medical supervision.

Pros of Troches:

1. Convenience: Troches can be taken at home, making them easy for ongoing maintenance therapy.
2. Non-invasive: No needles or injections are involved, which can be a relief for needle-weary individuals.
3. Lower Cost: Troches can be less expensive than in-clinic treatments.

Cons of Troches:

1. Absorption Variability: The way your body absorbs ketamine through the mouth or digestive system can vary. This variability may make the effects less predictable.
2. Lower Bioavailability: Only a small percentage of the ketamine in a troche actually makes it into your bloodstream, which can reduce its effectiveness.
3. Delayed Onset: Troches take longer to kick in, typically 20-40 minutes, compared to injections that take about 1 minute.
4. Limited Access to Medical Professionals: With at-home use, there’s no access to medical staff who can guide or support you during the experience.
5. Lack of a Controlled Environment: Unlike in-clinic treatments, troches don’t offer the safety and comfort of a supervised clinical setting.
6. Microdosing: Troches are often used in microdoses and do not produce the same profound mind-altering effects as IM ketamine, which can limit their therapeutic potential for some individuals.

What Is IM Ketamine?

IM (intramuscular) ketamine involves a direct injection of the medication into your muscle, typically in the upper arm. At Klarisana, all IM ketamine treatments are conducted in a clinical setting under professional supervision.

Pros of IM Ketamine:

1. High Bioavailability: IM injections deliver nearly all the ketamine directly into your bloodstream, leading to more potent and consistent effects.
2. Rapid Onset: You’ll begin to feel the effects within minutes, which can be crucial for individuals in acute distress.
3. Controlled and Safe Environment: Since the treatment occurs in a clinical setting, you’re monitored throughout the experience for both safety and comfort.
4. Deep Dissociation: IM ketamine is known for inducing a profound dissociative state, which many find therapeutic for processing trauma or achieving new mental perspectives.

Cons of IM Ketamine:

1. In-Clinic Only: IM treatments require scheduling appointments and traveling to a clinic.
2. Higher Cost: The comprehensive nature of in-clinic care often makes this method more expensive than troches.
3. Needle Involvement: Some people may feel anxious about receiving injections.

Other Options at Klarisana: Spravato Nasal Spray and Ketamine-Assisted Psychotherapy Subdermal Injection

In addition to IM ketamine, Klarisana also offers:

1. Spravato (Esketamine): This FDA-approved nasal spray is used to treat treatment-resistant depression. Like IM ketamine, Spravato is administered in a clinical setting under supervision to ensure safety and maximize its therapeutic potential. This option can be covered by insurance for some individuals with treatment-resistant depression. Contact us to see if you are a good candidate for Spravato. 
2. KAP: Ketamine-Assisted Psychotherapy (KAP) can also be administered via subdermal methods, which involve a slow release of ketamine over time. This approach supports deeper integration during therapy sessions and offers a unique way to tailor treatment to individual needs.

Why Klarisana Uses IM Ketamine

At Klarisana, we prioritize safety, effectiveness, and patient experience. Here’s why we emphasize IM ketamine in our treatments:

1. Clinical Supervision: Ketamine can produce powerful effects that are best managed with professional monitoring. Our trained and empathic staff ensures that you’re comfortable and supported throughout your journey.
2. Consistency: With IM ketamine, we can deliver precise doses and achieve predictable effects, which helps maximize the therapeutic benefits.
3. Enhanced Efficacy: The rapid onset and high bioavailability of IM ketamine allow for more profound and transformative experiences, especially for individuals struggling with conditions like treatment-resistant depression or PTSD.
4. Personalized Care: Every session is tailored to your unique needs. We guide you through the experience and offer integration support to help you make sense of the insights gained during treatment.

Choosing the Right Option

While both troches and IM ketamine have their place in mental health care, the choice depends on your specific needs, goals, and medical history. Troches may be suitable for maintenance therapy after an initial series of in-clinic treatments. However, if you’re seeking transformative results or need a higher level of care, IM ketamine in a clinical setting is often the better choice.

If you’re interested in exploring IM ketamine therapy, Spravato, or KAP options, Klarisana’s team is here to help. Contact us to schedule a consultation and take the first step toward feeling better.