Ketamine for chronic pain

Posted by ckeys @ckeys, Sep 3, 2019

My pain doctor recently prescribed ketamine as an adjunct to my pain management. Has anyone had experience with this? It has to be compounded and you inhale it through a nose spray. Since it’s compounded there is not much info on side effects so I’m curious about other’s experiences.

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@wheelerma

My doctors say they don't know what Ketamine is. Comments?

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Ketamine is an anesthetic commonly used for horses but is used also used for severe nerve pain such as fibromyalgia, CRPS, etc.
It is also used for status epilepticus.
It is powerful and has side effects such as hallucinations.
It works but only should be prescribed and administered by providers that know what they are doing. For CRPS, it is usually done IV in a clinical setting.

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@wheelerma

My doctors say they don't know what Ketamine is. Comments?

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@wheelerma I had a neurologist tell me the ketamine treatments I was having for depression were causing my headaches. I responded, "Amazing that it can cause headaches before even taking it, doctor!" I got a new doctor. Sorry for the snark. I can understand doctors not being up on all of the medications out there - there are a lot. Still, ketamine has done wonders recently for a lot of people with chronic pain and depression and has been on the news. It's an old drug with new uses. Did they say they would look into it or did they just dismiss it?

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@wheelerma @mandrake70 Sadly I have run across very few compassionate doctors recently

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@mandrake70

@wheelerma I had a neurologist tell me the ketamine treatments I was having for depression were causing my headaches. I responded, "Amazing that it can cause headaches before even taking it, doctor!" I got a new doctor. Sorry for the snark. I can understand doctors not being up on all of the medications out there - there are a lot. Still, ketamine has done wonders recently for a lot of people with chronic pain and depression and has been on the news. It's an old drug with new uses. Did they say they would look into it or did they just dismiss it?

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Dismissed! Some said they had never heard of it.

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@wheelerma

Dismissed! Some said they had never heard of it.

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@wheelerma @bustrbrwn22 I talked for six months or so with my psychiatrist about ketamine since nothing had worked for years. I finally went on my own and it worked wonders. He was pissed I went without consulting him. So, I am not currently seeing a psychiatrist. Doctors are people and fallible too. The problem I have had is that many don't listen to questions about new treatments that don't come from big pharma. I have a really good GP that looks at new options for things all the time. Very open minded. If you can find a doctor that will look into other options, ketamine or otherwise, you know you have one that is trying. If they won't look, then I don't know what you can do but find a new doctor.

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Thank you very much for taking time to reply. When you said you went on your own, what exactly did you mean? You researched it and then found a doctor? Do you take it by mouth or as a spray in your nose. Thank you again!

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@mandrake70

@wheelerma I had a neurologist tell me the ketamine treatments I was having for depression were causing my headaches. I responded, "Amazing that it can cause headaches before even taking it, doctor!" I got a new doctor. Sorry for the snark. I can understand doctors not being up on all of the medications out there - there are a lot. Still, ketamine has done wonders recently for a lot of people with chronic pain and depression and has been on the news. It's an old drug with new uses. Did they say they would look into it or did they just dismiss it?

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Traditionally trained doctors only see ketamine for what it has been used for in the past. It is being used for so much more now. Yes with side effects but they can be treated, or reduced with close observation. Are the rewards worth it? You tell me.

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@wheelerma

Dismissed! Some said they had never heard of it.

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That, my dear friend would be a lie. Everyone is medicine has heard of Ketamine.

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@wheelerma

Thank you very much for taking time to reply. When you said you went on your own, what exactly did you mean? You researched it and then found a doctor? Do you take it by mouth or as a spray in your nose. Thank you again!

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@wheelerma That's the problem with ketamine infusions - they aren't covered by insurance so there isn't a doctor involved unless the clinic hires one and it is expensive. The clinics aren't regulated so there are a wide variety of approaches, some of which don't work well. The clinic I researched in Rochester was started by a man that went through ketamine treatments years ago and wanted to offer it where I live. It's a very small operation but it does great work. I don't know about ketamine for chronic pain being insured or not. There is a new version of ketamine that is a nasal spray but it only uses one of the ketamine molecules, not both so it isn't always as effective. I don't know if that is usable for chronic pain. Sorry, that is a lot of "I don't knows." My experience is from depression treatments.

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Ketamine is tricky. You have to have specific doses and treatment delivery for specific types of pain and disease states to have effective outcomes. Please make sure your doctor is read up on the latest therapies and disease treatments for ketamine and not simply guessing because he wants to try another option.
Ketamine is not new on the market but can have amazing results IF it used correctly and administered in the correct manner for the disease State.
I.e. CRPS rarely responds to the oral dosage form but requires IV infusion over a period of weeks especially of the case of intractable or severe.
Fibromyalgia on the other hand has responded to oral ketamine but the dosage must be tailored to the specific pain level, not taken from a textbook.

This is a treatment that requires knowledge and training, not supposition or study from a CE or Pain conference by the peers, much less an article or two.

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