Migraine pain & chronic headaches are notoriously difficult to treat, but recent studies suggest that ketamine might offer new hope for those suffering from chronic migraines and headaches. As traditional treatments often fall short, the potential of ketamine as a therapeutic option is gaining attention.
We’ll explore the most recent research & reviews on ketamine and management of these conditions below.
Ketamine Infusions for Treatment Refractory Headache
In 2017, a study titled “Ketamine Infusions for Treatment Refractory Headache” reviewed 77 patients with chronic migraine (CM) or new daily persistent headache (NDPH) who received intravenous ketamine infusions. These patients had previously failed other aggressive treatments. The study revealed a significant reduction in headache pain, with average pain scores dropping from 7.1 at admission to 3.8 at discharge. The majority (71.4%) of patients experienced at least a two-point improvement in their pain rating. Although the immediate results were promising, the sustained response was less pronounced, highlighting the need for further research to confirm long-term benefits.
Ketamine for Refractory Chronic Migraine: An Observational Pilot Study
Another study, “Ketamine for Refractory Chronic Migraine: An Observational Pilot Study and Metabolite Analysis,” compared the effects of ketamine and lidocaine infusions in six patients with refractory chronic migraine. The findings indicated that both treatments provided short-term pain relief, but ketamine showed a greater reduction in pain levels by the end of treatment. The mean pain rating decreased from 7.4 to 3.7 during ketamine treatment. However, the pain levels increased again by the follow-up visit six weeks post-treatment, suggesting that while ketamine can offer significant short-term relief, its long-term efficacy requires further investigation.
Ketamine for Migraine in the Emergency Department
Ketamine’s use in the emergency department (ED) for migraine treatment has also been explored. The study “Ketamine for Migraine in the Emergency Department” reviewed data on the use of subdissociative doses of ketamine (0.2-0.3 mg/kg intravenously) for acute migraine relief. The results were mixed, with some studies showing effective pain relief while others did not. This inconsistency highlights the need for more robust evidence to determine the optimal dosage and administration route, as well as to establish ketamine’s place in migraine therapy.
The Potential of Ketamine Therapy to Help with Chronic Headaches & Migraines
Ketamine offers a unique mechanism of action by targeting N-methyl-D-aspartate (NMDA) receptors in the brain, which differentiates it from traditional opiate-based painkillers. This makes it a valuable option for patients with a history of opiate addiction.
Further, studies have shown that adverse effects, if at all are generally mild when administered at subanesthetic doses for headache treatment (mild nausea or dizziness). This suggests that ketamine could be a viable alternative for those who have not found relief with other treatments. The promising short-term results from various studies indicate that ketamine can significantly reduce migraine pain, but its long-term efficacy and safety remain to be thoroughly evaluated.
The studies reviewed provide a compelling case for the potential of ketamine in treating chronic migraines and headaches, particularly for patients who have not responded to conventional therapies. While the short-term benefits are evident, more research is needed to understand the long-term effects and optimal use of ketamine in this context. As the medical community continues to explore and refine ketamine therapy, it may soon become a cornerstone in the treatment of chronic headache conditions, offering hope to many who suffer from debilitating pain.
