The discovery of ketamine as a highly effective and rapid-acting treatment for chronic pain, particularly pain with a neuropathic component, has been hailed as arguably the most significant development in psychiatry during the past few decades.
Early Uses of Ketamine for Pain
Ketamine was first used as an anesthetic for battlefield surgery on American soldiers during the Vietnam War due to its large margin of safety. Since the 1990’s, clinical studies found uses for the anesthetic outside of the operating room. They discovered that ketamine was not only functional for short-term pain, but it can also be effective to treat chronic pain.
Chronic pain is a very common condition affects over 3 million people every year. This is a persistent sensation that occurs within the nervous system. In order to be considered “chronic,” the pain must last for more than 12 weeks.
In contrast to the ketamine dosage used as anesthetic during surgery, the dosage used to treat chronic pain is much lower. Ketamine is a safe and highly effective treatment for several chronic pain syndromes, especially chronic pain conditions that have a neuropathic component. Today, ketamine infusions are used to treat chronic refractory pain associated with fibromyalgia, neuralgia, complex regional pain syndrome (CRPS), and even cancer pain.
How does Ketamine work for pain?
IV ketamine, which can rapidly and robustly alleviate depression and suicidality, has also shown strong efficacy for treating chronic pain conditions including peripheral neuropathy, diabetic neuropathy, CRPS, phantom limb pain, cancer pain and patients with depression and pain, especially when conventional treatments have not provided satisfactory relief.
Ketamine produces strong pain relief by blocking the transmission of pain signals to the brain. Chronic pain has been linked to the activation of a neural receptor called N-methyl-D-aspartate (NMDA). When activated, NDMA can result in neuropathic pain. Ketamine has been proven to be a strong NDMA antagonist. It inhibits the NDMA receptor by blocking the release of glutamate, the most common excitatory neurotransmitter in the brain. In other words, ketamine blocks the communication of pain signals.
Ketamine is also thought to reduce signals in your brain that are connected to inflammation. Ultimately, ketamine works in several ways simultaneously to ease your sense of pain through its anesthetic properties.
Ketamine for Cancer Pain
With an overall prevalence of 50.7% in all cancer stages, pain is commonly encountered by cancer patients. The pain can be anywhere from dull, sharp, achy, or burning. It can be consistent or sporadic while ranging from mild to severe. Unfortunately, 20-40% of the pain is not adequately alleviated by standard treatments.
Research has shown that IV ketamine has proven to be both safe and effective for cancer-related neuropathic pain. Ketamine for pain has shown surprisingly quick and long-lasting results. In multiple studies, IV ketamine treatments have produced sustained pain relief for months after a series of treatments. Specifically, one study found ketamine substantially reduced chronic neuropathic pain after 30 minutes and a second set of studies using multiple infusions of ketamine relieved pain for three months or more.
Depression and Chronic Pain
There is considerable comorbidity with chronic pain and depression and there is also overlap in terms of treatment, with many therapies typically used to treat one being effective for the other, like IV ketamine therapy.
IV ketamine therapy has generated enormous interest for the treatment of depression and chronic pain among health care providers, patients and their caregivers, and patient advocacy groups. Research has found ketamine to be effective for both chronic pain and depression, and recent years have witnessed a dramatic increase in research and publications, clinical use, and publicity.
Patients treated with IV ketamine for chronic pain may be able to reduce or eliminate their dependency on prescription medications, like opioids, to manage their symptoms. The may also find that they are able to make greater progress in therapy or in adapting other lifestyle changes needed to help keep chronic pain at bay.
When to Consider Ketamine for Chronic Pain
In contrast to the slow onset of antidepressants and other medications, ketamine for chronic pain has shown surprisingly quick and long-lasting results. In multiple studies, IV ketamine treatments have produced sustained pain relief for months after a series of treatments. Specifically, one study found ketamine substantially reduced chronic neuropathic pain after 30 minutes and a second set of studies using multiple infusions of ketamine relieved pain for three months or more.
If medications and nonpharmacological interventions have not provided adequate pain relief, IV ketamine therapy may be a treatment option. IV ketamine is known for its ability to help relieve medication-resistant chronic pain syndromes, especially those syndromes that have a neuropathic component, such as complex regional pain syndrome type 1 (CRPS-1), post-herpetic neuralgia and neuropathic pain from peripheral nerve damage. With IV ketamine infusion therapy, it’s possible to experience an improvement in your pain or mood within just a few hours.
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