Recently, however, there has been much interest in the role of ketamine as a treatment for chronic pain management, and doctors have begun to prescribe low doses of this medication to patients with chronic pain conditions such as complex regional pain syndrome (CRPS).
Ketamine is a drug with sedative (sleep-producing), analgesic (pain-relieving), and amnesic (short-term memory loss) effects. It combats pain by acting against a specific chemical receptor known as N-methyl-D-aspartate, or NMDA, which is found in the nervous system and, in part, modulates pain. However, ketamine interacts with other receptors as well, broadening its clinical uses.
When Should Doctors Use Ketamine?
Generally, two types of patients with chronic pain may benefit from this medication: patients with chronic pain that have not had much success with other pain medications or treatments, and/or patients with chronic pain who plan to undergo surgery.
“I think of ketamine as a very effective pain medicine for a small number of patients: In general, patients who have been taking opioids for pain and found them to be ineffective,” Charles F. von Gunten, MD, PhD, vice president of medical affairs for Palliative and Hospice Medicine at Ohio Health in Columbus, OH, told PPM.
Several conditions, including cancer, CRPS, fibromyalgia, neuropathic pain, phantom pain, postherpetic neuralgia, sickle cell disease, and spinal injury, may result in chronic pain. Ketamine has been used to manage pain in all of these conditions.