Ketamine is a anesthetic medication that has been in use for over 20 years for the treatment of neuropathic pain and more recently for the treatment for a variety of psychological disorders and Mast Cell Activation Syndrome.
The neuropathic pain conditions that have been effectively treated with ketamine include:
Complex Regional Pain Syndrome
Phantom Limb Pain
Neuropathic abdominal and pelvic pain syndromes : such as the pain associated multiple abdominal surgeries, endometriosis, interstitial cystitis, vulvar pain.
Ketamine is appropriate for severe or persistent depression despite conventional treatment. It has also been beneficial for patients with associated anxiety and post traumatic stress disorder.
In the treatment of Mast Cell Activation Disorder, Ketamine not only treats the pain often associated with this disorder, but also acts as a mast cell stabilizer decreasing the number of attacks and improving a constellation of other symptoms.
For pain conditions and MCAS, it is a four hour treatment, with an initial course of three consecutive days. For depression, it is a one hour treatment, again with an initial course of three consecutive days.
The need for subsequent infusions are highly individual and a treatment course is decided on for each patient. Typically, all pain and depression patients require boosters, that maybe be needed one month to up to six months after the treatment.
The most common side effects of the infusions are headache and nausea, both are easily controlled with additional medication given before and during the infusion. Hallucination is also a well known side effect, but again these are easily controlled with sedative medication during the infusion. Hence the vast majority the patients sleep through the infusion.
The risks associated with this treatment, while extremely rare, are cardiac arrythmias, liver enzyme elevation and respiratory compromise.
All side effects and risks are minimized by obtaining lab work prior to infusions, medical clearances and psychological clearance as required by a patients’ history. All Patients are monitored during the infusion by a physician on site at all times. There is one to one patient nursing. Of note all patients undergoing treatment for depression must obtain clearance by a psychiatrist and have appropriate psychological follow up in place prior to undergoing the infusion.
Patients are required to have rides arranged to and from infusions, as well as an adult at home to stay with them through the night following an infusion.