Ketamine, typically thought of as an anesthesia medicine or even a club drug, is now generating a lot of interest amongpain management specialists as a useful approach to hard-to-treat migraines and chronic pain.
The use of ketamine against these chronic pain conditions was discussed in separate sessions at the American Academy of Pain Management 2016 annual meeting. In a presentation, Duren Michael Ready, MD, a headache specialist at Baylor, Scott & White Health in Temple, TX, cited research showing that a 25-milligram ketamine nasal spray reduces severity of aura in migraines, and that a 10- to 50-milligram dose is safe for “breakthrough pain” -- sudden flares of severe pain.
In addition, ketamine can address depression, which is often seen in pain conditions such as migraines. According to Ready, 50 milligrams of ketamine nasal spray is effective for treatment-resistant depression.
Ketamine is not for all patients, Ready says. "It's not something you want to pull out for everyone, but it might it be useful for someone not getting better with typical treatments.”
He stresses that ketamine should be prescribed carefully. "You want to kind of limit how often patients use it,” while also making sure they're working to prevent chronic migraines, he says.
Neurologist Hisham Hakim, MD, chairman of the American Spine Center in Birmingham, AL, agrees.
"We need to bring in unusual treatments for those tough cases, such as patients with chronic resistant headache," he says.
In addition to using a topical ketamine cream, migraine patients can use the nasal spray. "These are not doses at a level that will produce sedation, but at levels that can help block the pain," Ready says.
A side effect of ketamine in people who have headaches could behallucinations or having an "out of body" feeling, he says.
In a separate presentation, Ben Keizer, PhD, of the San Antonio Military Medical Center in Texas, and Justin Boge, DO, of the Evans Army Community Hospital in Fort Carson, CO, discussed, among other things, using ketamine in veterans with a chronic pain condition known as complex regional pain syndrome and post-traumatic stress disorder (PTSD).
source : http://www.webmd.com/migraines-headaches/news/20160928/ketamine-may-treat-migraine-chronic-pain
ConversionConversion EmoticonEmoticon