Why Ketamine?
Ketamine infusions may treat a variety of pain conditions, including:
- CRPS / RSD
- Neuralgias, including Trigeminal Neuralgia and Occipital Neuralgia
- Pudendal Pain
- Fibromyalgia
Severe and chronic pain can be debilitating. Many people suffering with pain have lost jobs, friends and family relationships due to their illness. Many have been forced to give up activities they love and most also suffer with anxiety and depression related to their condition.
For appropriate conditions, ketamine for pain management can be an exceptional treatment option. All the information that we have from studies and clinical results indicate that ketamine works at the level of neurons – improving their healthy function. If pain is based in the neurons themselves then ketamine can help. If there is an ongoing injury causing the pain then ketamine is unlikely to help.
Patients who achieve positive results often maintain improvements for years with regular boosters. Many of our patients have decreased or stopped their narcotic usage and many have regained the ability to have meaningful hobbies or careers.
You should generally be able to tell if ketamine treatments will help after the first infusion. Once we have established that ketamine treatments are effective for your pain, we work with you to tailor the treatments. The limiting factor for treating severe and chronic pain conditions is the time, expense, and the safety/side effect profile of ketamine. Ketamine is a general anesthetic at high enough doses.
Ketamine Treatments for Pain Management
The most appropriate infusion option for pain conditions can vary significantly.
- For treating Fibromyalgia, for instance, the most appropriate course of treatments often appears to include a series of one-hour low-dose infusions very much like a course of treatments for psychiatric symptoms
- Low-dose infusions typically start around 0.5 mg/kg/hr of ketamine and are adjusted to the appropriate response of the patient.
- Low-dose infusions are typically one-hour in duration including 40 minutes of active infusion and 20 minutes of active recovery.
- For other chronic pain patients, the most appropriate course of treatments is often one, two, or three higher-dose infusions as-needed.
- High-dose infusions are adjusted to the appropriate response of the patient.
- High-dose infusions are often provided in one-hour
Patients typically describe the experience of a low-dose infusion as floating and may experience mild visual hallucinations and other similar mild side effects of the disassociate anesthetic that wear off quickly after the infusion. High-dose infusions are a much larger total dose of ketamine, and other adjunct drugs are often provided to limit potential discomfort, for the regulation of heart rate and other functions, and to reduce nausea. In all cases, we work hard to avoid uncomfortable experiences. For comfort and safety, we provide Anesthesiologist/Anesthetist administration, continuous monitoring, emergency medications, emergency equipment, and protocols consistent with best practices for the procedure and with the Texas Medical Board Codes for office-based anesthesia.
We work with our patients to determine treatments and frequencies that will work best for them. For fibromyalgia, we may see patients for a series of low-dose infusions followed by maintenance treatments – similar to the treatments for many psychiatric conditions. For other pain conditions, like CRPS, we often see patients for one-hour high-dose infusions. Treatment regimens can vary, but a common course of treatments may be one or more treatments to begin with followed by one or two treatments every six to eight weeks to manage symptoms. We have some patients who are maintaining their results with as little as a one-hour infusion every eight weeks, although this is after many years of treatment.
The number and frequency of treatments are variable from patient to patient. We work with each patient to find the best treatment approach for them.
High-Dose Infusions
- Used for other chronic pain conditions such as CRPS.
- Often provided in one-hour sessions.
- Doses are adjusted to patient response.
Patients typically describe the experience of a low-dose infusion as a floating sensation and may experience mild visual hallucinations or other mild side effects that wear off quickly. High-dose infusions involve a larger total dose of ketamine, often with additional medications to manage potential discomfort, heart rate regulation, and nausea.
