If you suffer from chronic pain, you may have heard about ketamine’s pain-relieving effects. This article will describe whether ketamine is effective in cream/gel form and compare it to IV infusions. Keep reading to learn more about the different forms of ketamine and determine which one is the right choice for you.
What is ketamine, and how does it work?
Ketamine (also known by the brand name Ketalar) is approved by the Food and Drug Administration (FDA) in the United States as a dissociative general anesthetic. This means that it makes you feel disconnected from reality and your surroundings and puts you in a sleep-like state. Doctors use ketamine to induce short-term loss of consciousness for medical procedures such as repairing wounds in uncooperative patients (such as children) or treating dislocated joints.
Low doses of ketamine that do not cause dissociation can be used to treat severe pain caused by a variety of conditions, including:
- Abdominal pain
- Arm pain
- Leg pain
- Lower back pain
Unfortunately, ketamine has also developed a reputation as a popular street drug because it can relieve pain, distract users from reality, and cause hallucinations if used incorrectly. However, recreational users initially reported in 1975 that ketamine had effects similar to antidepressant medications2. But this anecdotal evidence could not be used because ketamine was illegal. The first study of ketamine’s therapeutic effects on humans was published in 2000.
Which ketamine therapy is more effective at treating pain – topical or infusion?
Some studies show that pain medications, antidepressants, and low-dose ketamine infusion therapy can effectively treat complex regional pain syndrome 3 (CRPS) and residual limb pain4. Because ketamine can treat pain and depression, taking ketamine to treat CRPS or residual limb pain may make it possible for you to manage your symptoms with fewer medications.
There are several risks and benefits5 associated with using ketamine to treat chronic neuropathic pain.
One of the benefits of ketamine for chronic pain management is that it inhibits the N-methyl-D-aspartate receptor (NMDAR), which sends pain signals to your brain.
One of the risks of using ketamine to manage chronic pain is that long-term infusion therapy is needed every 4-6 weeks, and repeated treatment can cause damage to your internal organs in the long term.
Ketamine is also an expensive medication, which can put financial stress on users over time.
More research needs to be done to determine whether the benefits of using ketamine for chronic pain outweigh the risks and costs. Until the benefits have been fully proven, ketamine should only be used to treat neuropathic pain that is severe and treatment-resistant.
However, a randomized controlled trial 6 (RCT) that involved 21 patients with refractory CRPS showed that receiving ketamine infusions for four hours each day for five days (0.35 mg/kg/h max dose) reduced their pain by 21.4% compared with patients who received placebo.
The importance of medical guidance when using ketamine
Ketamine should only be taken with the supervision and guidance of an experienced and licensed healthcare professional. Some of the risks that a healthcare professional can help you avoid by properly monitoring your ketamine treatment include the following:
- Addiction is a concern because there is a potential for misuse of ketamine.
- Cognitive (thinking) defects can occur in children who are given ketamine.
- Emergence reactions, such as agitation or confusion, may occur when waking up from ketamine anesthesia.
- Increased intracranial pressure should be monitored if you have a history of increased intracranial pressure.
- Liver injury, which the administration of ketamine can cause.
- Respiratory depression can occur if ketamine is administered too quickly or if you overdose on it.
- Unstable blood vessel function may temporarily increase or decrease your blood pressure.
- Unstable heart function may temporarily increase or decrease your heart rate and/or cause abnormal heart rhythms.
With proper supervision by a licensed and trained doctor, ketamine infusions can effectively address pain symptoms better than treatments administered topically. Intravenous (IV) ketamine is more effective than topical ketamine cream and gel because it goes directly into your bloodstream and begins to take effect immediately.
In contrast, topical ketamine is absorbed into your body by passing through your skin cells, which can take a long time and delay the effectiveness of the treatment. IV ketamine infusions can also be given in higher doses than topical ketamine treatments.
Taking ketamine to treat CRPS or residual limb pain can help you reduce the number of medications you take to manage your pain. For example, ketamine may be able to replace antidepressants and pain medications used to treat CRPS and residual limb pain.
Contact your doctor today to discuss whether ketamine is the right chronic pain management treatment.
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