KETAMINE – A Treatment For Chronic Pain, Refractory Depression and Addiction
Ketamine is a drug that was synthesized in 1962 by Parke Davis Labs. It has been used since 1970 as an FDA approved anesthetic and is on the World Health Organization’s essential medicine list. Ketamine is a dissociative anesthetic, and it has advantages over other forms of anesthesia in emergency situations. Ketamine does not compromise the airway, and thus, intubation is not required for its use, which makes it useful in situations where anesthesia needs to be rapid. It can cause mild increases in heart rate and blood pressure. Ketamine is a dissociative anesthetic, and at lower doses, can cause mild hallucinations and perceptual changes, while at higher doses it can induce a trance-like state with more profound dissociative and hallucinogenic experiences. The dissociative properties of Ketamine are what make it useful as a standalone anesthesia in situations such as the battlefield, and emergency rooms to treat burn victims or pediatric dislocations that need to be set quickly.
For decades, Ketamine has been used “off-label” to treat chronic pain, depression and PTSD. Recent studies have demonstrated Ketamine’s ability to rapidly and completely reverse suicidal depression in treatment-refractory patients. No other treatment modality has demonstrated such a rapid and profound response since electric convulsive therapy (ECT). However, unlike ECT, treatment with Ketamine infusions do not require an inpatient hospital stay, and the side effect profile is more favorable then ECT which can cause memory loss. Many severely depressed patients improve significantly in a matter of hours post treatment. Multiple rounds of infusions are usually required for a sustained response to Ketamine. Current research is focusing on how to best use Ketamine as a treatment for sub-classes of refractory depressed patients such as those suffering with chronic pain, addiction and other psychiatric disorders. Ketamine is a good alternative to patients who are medically addicted to painkillers and want to get off of them but need effective treatment for their chronic pain condition.
We administer Ketamine to patients suffering from chronic pain, depression and addiction, under the supervision of a licensed Anesthesiologist and a licensed Addiction Psychiatrist – all within a AAAA licensed surgicenter. Many practitioners administer Ketamine in office-based settings that are not prepared to administer anesthetics in this way, and furthermore, they do not provide mental health services. We work directly and collaboratively with referring pain management doctors and psychiatrists. To that end, a requirement for treatment in our center is that patients MUST CONTINUE TO SEE THEIR REFERRING DOCTOR.
Our goal is to provide a treatment modality that improves patient care, and allows patients to remain under the care of their referring physicians.
Ketamine infusions are administered weekly by IV infusion. Most patients require anywhere from 3-8 infusions to achieve a robust, clinical response. After that, lower “booster” doses of Ketamine can either be infused, or administered by intra-nasal route.
Schwartz, J. Murrough W., et al. ,”Ketamine For Treatment-Resistant Depression: Recent Developments and Clinical Applications”, Evidence-Based Mental Health, 2016; 19(2): 35-38.