US News article on Ketamine Infusions for pain

https://health.usnews.com/health-care/for-better/articles/ketamine-infusions-for-chronic-pain

Can a decades-old medication used for anesthesia help with pain management?

Chronic pain is defined as pain that persists longer than three months after a known injury has healed, or if an ongoing injury persists. Chronic pain affects 1 in 5 people living in the United States – more than heart disease, cancer and diabetes combined – and nearly a third of those have pain that limits their ability to work or live life.

Treatments for Chronic Pain

Conventional pain management and treatment consists of:

• Improving diet, exercise and sleep.
• Physical therapy.
• Medications.
• Injections and surgery.
• Pain psychology (i.e., helping patients improve functioning by recognizing the connection between their pain, emotions, thoughts and behaviors).

What Is Ketamine?

Ketamine is a general anesthetic, a medication used to put patients to sleep for surgery or procedures. It was first approved for general anesthesia in 1970.

Shortly after its approval, physicians began to notice that lower doses of ketamine had positive effects on chronic pain, and since then, numerous published studies and reports support these observed effects. Low-dose ketamine has also been shown to benefit patients with treatment-resistant depression.

Ketamine for Chronic Pain

Exactly how ketamine works to help chronic pain is unclear. Studies show that it’s much more complex than we previously thought. We know that ketamine attaches to specific areas of the spinal cord and brain that are responsible for pain signals and emotion. After it attaches, it leads to changes that may decrease pain and improve mood.

Unfortunately, we know that ketamine does not work for everyone, and it often works differently for individual patients. When it does help, patients may notice pain relief immediately, or the pain relief may be delayed (after a few days or weeks). This relief can vary in length – some patients report pain relief for a few days, whereas other patients notice pain relief for a few months or longer.

Ketamine Infusions and Side Effects

Ketamine infusions are administered through an IV at a clinic or hospital. Patients come in for multiple infusions on separate days over the course of one to four weeks. The infusions can last anywhere from 40 minutes to many hours.

Side effects of the infusions are dependent on the dosage of the ketamine. At low doses, side effects are rare and easily treated and include headache and nausea. As the dose increases, side effects include hallucinations, anxiety, and increases in blood pressure, which are also treatable during the infusion.

Is Ketamine an Option for You?

Before an infusion is scheduled, you and your physician can discuss your interest in ketamine and see if you are a good candidate. Specific questions about your heart, lungs, brain, liver and other organs will be asked, as there can be more serious side effects at higher doses on those organ systems. If you have a history of health concerns, the dosage can be changed to lower your risk of side effects.

Patients who battle chronic pain know that there are multiple treatments that can provide some degree of relief. Ketamine infusions gives these patients one more option in that fight.