If you are suffering from a type of chronic pain condition that responds to ketamine, you will find that ketamine infusions can be life changing, if not life saving. Ketamine can be an effective alternative to other medications, such as opiates, painful injections, spinal cord stimulators and other therapies that have not been helpful and often cause only disappointment, frustration and unwanted side effects.
When you’ve tried everything to ease chronic pain and nothing seems to work, ketamine infusion therapy may be the answer!
First and foremost, ketamine has been used as an important human general anesthetic agent for the past five decades. Because of its versatility and safety, ketamine has been included in the World Health Organization’s list of Top 10 Essential Drugs.
For the past 25 years, ketamine — in sub-anesthetic doses — has found new importance in the treatment of mood disorders and chronic neuropathic pain conditions that have become “centralized.”
In some patients, for reasons that are unclear, injury to either peripheral nerves or the central nervous system (i.e. brain or spinal cord), causes neuroinflammation. This results in the activation of glial cells that release cytokines in the brain’s pain centers. The brain reacts through the autonomic nervous system causing chronic, intractable pain throughout the body, often accompanied by peripheral swelling, discoloration, temperature changes and allodynia (sensitivity to touch).
The traditional method for dealing with neuropathic pain is to dull the signals with prescribed pain medication, nerve blocks and other injections. Unfortunately, these treatments are often accompanied by significant, long-term side effects and do little to attack the underlying problem – they simply mask the pain.
Ketamine blocks NMDA receptors in the spinal cord. This prevents the glial cells from sending information to the brain during the infusion period. The brain stops releasing cytokines and is “rebooted.” By interrupting the process during treatment, prolonged relief of pain and other symptoms follow. Why this occurs is less clear, but ketamine does work effectively in treating most patients with central pain syndromes.
Certain types of Central Pain Syndromes are particularly responsive to ketamine therapy. They include:
If your doctors have told you that you have a central pain syndrome that is not
responding to oral medications, nerve blocks or a spinal cord stimulator, we
should be able to help. You or your doctor can call Dr. Brooks or one of the
doctors in our satellite offices to discuss your chronic pain condition. With
just a phone call, they should be able to determine if ketamine infusion therapy
is likely to help you.
(Sorry, but treatment for neuropathic pain is not available in our Madrid office.)
There is finally hope for people with debilitating pain who have run out of other options. With individualized treatments based on Dr. Brooks’ unique protocols, roughly 4 out of 5 of our patients experience moderate to excellent pain relief. Ketamine’s effects can be dramatic, often allowing patients to re-engage in life’s daily activities.
We design unique treatment protocols and dosages for each of our patients, depending upon the nature of their pain and their initial response. In most cases, we will administer three infusions on three consecutive days. In cases where the diagnosis of a central pain syndrome is less certain, we will begin with one infusion to determine if ketamine will help your pain.
The ketamine is administered by slow intravenous infusion over four hours. Other medications are also administered intravenously. Each infusion is followed by a three to four hour recovery period before you are ready for discharge.
Following successful treatment, patients are generally placed on an oral ketamine supplement, and appointments for single follow-up infusions are scheduled for two, four and eight weeks after the initial series. Thereafter, patients often return for single boosters if and when they have a flare up of their pain. The intervals between boosters vary by patient and cannot be easily predicted. We see most of our patients twice a year, as needed.
While our success rates are high, no treatment is 100% effective in treating all chronic pain. If you have one of the above conditions, however, our success rate in achieving dramatic improvement in your pain is at least 80%. With prolonged pain relief comes improved function and the probability of returning to school or work, or simply being able to once again lead a more normal, full, active life.
Ketamine infusions are generally well-tolerated. The doses used would cause hallucinations if the ketamine was given alone. To prevent any unwanted hallucinations, we use benzodiazepines and, in some cases, propofol during the infusion. As a result, most patients comfortably doze off during the infusion and awake with no recall or unpleasant side effects.
A small number of our patients experience nausea. To prevent this possibility, we use two different antiemetics. An occasional patient will have a headache after awakening. We provide medication to alleviate this issue as well.
No one needs to be with you during the treatment, though friends and relatives are welcome. Our experienced nursing staff is always there to care for you during and after treatment. We do require that a responsible adult picks you up at the end of the recovery period each day to bring you to your home or hotel, and then stays with you overnight. We can provide you with a list of local hotels if you don’t live in the area, and we can arrange for a wheelchair if needed.
Please do not eat or drink anything after midnight the night before your infusion. The only exceptions are your meds which you should take with a sip of water.
You will discuss your current medications with the doctor before your first appointment. Since nearly all medications are compatible with ketamine, it is likely that you will be able to continue taking them.
In most cases, yes. The protocols we use to treat mood disorders and pain are very different with no direct crossover because of the different mechanisms of action and doses used. However, with dramatic pain relief and a return to normal function, you should enjoy mood improvement and less stress.
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