Ketamine infusions may treat a variety of pain conditions, including:
- CRPS / RSD
- Neuralgias, including Trigeminal Neuralgia and Occipital Neuralgia
- Pudendal Pain
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 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 than 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. In general, studies appear to show, and clinical results appear to support, that for treating severe and chronic pain conditions the more ketamine given the more effective the treatment- the greater the pain relief and the longer the duration of pain relief. The limiting factor really becomes the time and expense.
The most appropriate infusion option to treat 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 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 high-dose infusions as-needed.
- High-dose infusions typically start around 2 mg/kg/hr of ketamine and are adjusted to appropriate response of the patient.
- High-dose infusions are often provided in one-hour or four-hour durations.
- Four-hour infusions include 4 hours of active infusion and about 2 hours of active recovery – usually requiring patients to spend 6 to 7 hours in the office before being released to go home.
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 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 physician 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 four-hour high-dose infusions on an as-needed basis. 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 is variable from patient to patient. We work with each patient to find the best treatment approach for them.