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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@faithwalker007

My pain specialist wants to prescribe Ketamine orally for me for my CRPS (type 2.) I've discussed it with my neurologists and they don't believe it will be effective and I'm a high risk due to my Seizure Disorder and migraines. It may "help" or not either one of those at the risk of sending their controlled status out of whack as well.
I really don't know what to do. Both neurologists recommend IV ketamine for CRPS especially since I am progressing, but no other method.

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In reply to this message,I have discovered that due to my grand mal seizures, I’m not a candidate for ketamine. Bummer... i do not discourage this treatment but PLEASE make sure you are getting from a provider who knows what they are talking about not someone who is guessing.

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My pain doctor gave me a brochure about Ketamine that was published by the U.S. Dept. of Justice's National Drug Intelligence Center. I'm guessing that it was not written by doctors, but by law enforcement personnel, so expect their slant. "Ketamine is an anesthetic that is abused for its hallucinoginic properties. Its predominant legitimate use is as a veterinary anesthetic; however, it has been approved for use with both animals and humans. Abuse of the drug gained popularity when users discovered that it produced effects similar to those associated with PCP."

Hmmm ... I wonder who was the first person who looked at their dog's medicine and thought "I'll take some of this and see what it does to me" ... Peggy

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The brochure also says that common names for ketamine are: K, special K, cat valium, vitamin K; street names are: Green K, Honey oil, Jet, Ket, Kit kat, Purple,. Special la coke, Super Acid, Super C.

Risks: "Ketamine can cause depression, delirium, amnesia, impaired motor function, high blood pressure, and potentially fatal respiratory problems."

It's too scary for me. Peggy

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@pfbacon

The brochure also says that common names for ketamine are: K, special K, cat valium, vitamin K; street names are: Green K, Honey oil, Jet, Ket, Kit kat, Purple,. Special la coke, Super Acid, Super C.

Risks: "Ketamine can cause depression, delirium, amnesia, impaired motor function, high blood pressure, and potentially fatal respiratory problems."

It's too scary for me. Peggy

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After being patented by Parke-Davis for human and animal use in 1966, ketamine became available by prescription in 1969 in the form of ketamine hydrochloride, under the name of Ketalar. It was officially approved for human consumption by the United States Food and Drug Administration in 1970 and, because of its sympathomimetic properties and its wide margin of safety, was administered as a field anaesthetic to soldiers during the Vietnam war.
Ketamine is now being used to manage treatment-resistant depression. Indeed, 25 years before the first randomised controlled trials of ketamine in depression by Berman et al. and by Kudoh et al. demonstrated that low-dose ketamine improves the postoperative state of depressed patients, Sofia had experimentally observed that ketamine possessed an antidepressant activity.63 As, contrary to ordinary antidepressants, ketamine does not act within weeks, but within only a few hours, it has been proposed as a potential fast antidepressant in patients with high suicidal risk.
Today, the interest in ketamine continues. Its value and safety in anaesthetic and analgesic management have been demonstrated in thousands of patients, and after more than 50 years, ketamine makes a true clinical comeback in the affluent world. In the less affluent world, and since the Vietnam war 40 years ago, it has remained a crucial sole anaesthetic agent enabling surgery to be performed where, without it, nothing would be possible.
https://journals.lww.com/ejanaesthesiology/Fulltext/2017/09000/History_of_anaesthesia__The_ketamine_story___past,.2.aspx

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@pfbacon

My pain doctor gave me a brochure about Ketamine that was published by the U.S. Dept. of Justice's National Drug Intelligence Center. I'm guessing that it was not written by doctors, but by law enforcement personnel, so expect their slant. "Ketamine is an anesthetic that is abused for its hallucinoginic properties. Its predominant legitimate use is as a veterinary anesthetic; however, it has been approved for use with both animals and humans. Abuse of the drug gained popularity when users discovered that it produced effects similar to those associated with PCP."

Hmmm ... I wonder who was the first person who looked at their dog's medicine and thought "I'll take some of this and see what it does to me" ... Peggy

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Again, you need to have a doctor who is on the cutting edge of pain treatment for them to know about ketamine therapy. Your doctor doesn’t sound like he is. Or he is towing the DEA line. Sorry.

Ketamine is not a new aesthetic and has been around for years. Yes, it has been abused by people for its side effects especially with PCP in the 60s and 70s. It’s side effects is why it is predominately used on horses and dogs. But it is an amazing aesthetic.

It is currently being used in specialty clinics and compounded by compound pharmacies and prescribed by knowledgeable Pain specialists for intractable, intractable pain especially for incurable disease states such as Complex Regional Pain Syndrome type 2 or Causalgia, Fibromyalgia, and others.

It is NOT used randomly or usually. It is used in untreatable or failed cases.

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@faithwalker007 You are a wealth of information Thanks One problem I have is Fibromyalgia but the side effects of Katamine scared me so haven't asked my Dr she is a Dr of Osteopath

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@pfbacon

The brochure also says that common names for ketamine are: K, special K, cat valium, vitamin K; street names are: Green K, Honey oil, Jet, Ket, Kit kat, Purple,. Special la coke, Super Acid, Super C.

Risks: "Ketamine can cause depression, delirium, amnesia, impaired motor function, high blood pressure, and potentially fatal respiratory problems."

It's too scary for me. Peggy

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Those are street names not medical names. Please don’t let the illegal use of a drug keep you from relief. Especially if you have no other options. Ketamine has been around since the 60s.
Sudafed can be used safely and knowledgeably by the public. It also can be turned into a nightmare. It is controlled now so only the right people can get it. Does that happen all the time? No. Would you use it if you could to make meth, ice, crystal, or any other names that pseudoephedrine can become? Or would you use pseudoephedrine to treat a cold?
Don’t let the seedy, criminal side of life decide your healthcare.

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@lioness

@faithwalker007 You are a wealth of information Thanks One problem I have is Fibromyalgia but the side effects of Katamine scared me so haven't asked my Dr she is a Dr of Osteopath

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Sorry I guess you need to do what’s best for you. I’m sorry if I intrude. I just don’t want anyone to let fear stand in the way of their therapy.

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@faithwalker007

Sorry I guess you need to do what’s best for you. I’m sorry if I intrude. I just don’t want anyone to let fear stand in the way of their therapy.

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I’ve seen it more times than I can count and people suffer needlessly or at least without trying something that may have helped. I can’t take ketamine. Would I? Yes. I can only get 40% Pain relief tops on a good day. I hate taking opioids. I’ve never taken them until I developed CRPS. I swore I would never have to.
I guess we should be careful what we say.

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As far as being a “wealth” of information? I don’t know about that. I’m a pharmacist of 23 years, not active but still licensed. I’ve worked 12 years for the federal government - 8 with Indian Health and 4 with the VA, the rest divided between retail, hospital, and long-term care, the majority retail.
My husband has been disabled for 15 years and has had 39 surgeries. He has post-surgical chronic pain syndrome and loose joints from prescription steroids, at least that’s what we believe. No doctor will confirm it due to legal risk. He also was born deaf and with a hard cleft palate and lip but has had reconstructive ear surgery with implants and has partial hearing in one ear.
I am now disabled with CRPS Type 2 or Causalgia. In addition, I have had 25 surgeries in my lifetime. I was born with a soft cleft palate and have had numerous related surgeries as well as emergency surgeries and orthopedic surgeries. I have severe migraines and epilepsy involving tonic-clonic seizures with onset during my pharmacy education at university. The hormonal switches by my campus doctor and stress due to having a small child and economical problems (I was told) led to the seizure activity and lowering of the seizure threshold. I have had intractable migraines and seizure activity since I was 14yo.
My joint issues arrived with an injury at the VA and subsequent repairs but during that first injury was the discovery of severe osteoarthritis at the age of 26. I was told I had the knee joints of a 65 year old woman.
I worked and maintained my pain with Celebrex and continued on through multiple surgeries and emergency situations and life with a son and soon to be disabled husband.
I became a pharmacy manager and soon after was unable to walk on a knee which refused to hold me physically or painfully.
Doctors reluctantly admitted I needed a TKR at 49 years of age and completed their sworn duty miles and miles away from my home.
Afterward, CRPS developed unbeknownst to me, much pain, and suffering, nine doctors visits, and after one and a half years of stress and hopelessness, I was finally diagnosed with the most painful disease known to man—Causalgia.
Unfortunately, I’m still traveling to see my doctor miles and miles away. I’m still fighting for pain relief. I’m still searching for answers. And I’m still combating a government that wants to take the only thing that gives me relief away.

But...

I will always— always be here to impart any information I have through experience or knowledge to help anybody who needs it.

If I ever step on toes though, please don’t hesitate to push me off of them. Do it gently though. I don’t want to fall.

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