Using ketamine for pain is not a new idea. But I think we’re going to see it get an increasing amount of attention in the months ahead.
A few weeks ago, NPR featured a news story on the use of ketamine for depression. Ketamine, originally developed as a human anaesthetic, has since been used for various applications in medicine.
It’s also used as an illegal drug, gaining fame as "K", "Vitamin K" or "Special K".
In recent years there has been sporadic interest in using ketamine for pain. It’s a difficult drug to study, because it tends to be rather obvious that you’ve taken it.
But it has been suggested as a treatment for cluster headache, familial hemiplegic migraine, chronic daily headache, and migraine, as well as other types of pain.
Ketamine is a neurological drug, classed as a NMDA (N-methyl-D-aspartate) receptor antagonist. It is believed to work in a number of different ways in the brain – relating to calcium channels, serotonin, and glutamate – terms that will be familiar with migraine researchers in particular. In fact, ketamine has been especially useful in the treatment of headache or migraine that just won’t go away and isn’t responding to other kinds of treatment (refractory). It’s given as an IV or intranasal treatment. Of course, this means it’s way down on the list of treatments that will be given – it’s rare and even when it’s tried it’s often not successful.
However, with the growing interest in ketamine for depression, the game changes. You can bet that there will be increased interest in ketamine for chronic pain conditions, which often come hand in hand with depression.
Although increased interest doesn’t mean this should be the drug of choice for most people, it does mean that more research will be done. It may be a treatment that will help a few patients whose pain is seemingly unstoppable.
For more on the background of ketamine, read Ketamine and MDARs in the treatment of neuropathic pain from Dr. Jan M. Keppel Hesselink. For a review of the studies on ketamine for other types of pain aside from headache, read Ketamine in Chronic Pain Management: An Evidence-Based Review