Introduction

Ketamine therapy is a newer approach to managing chronic pain. While early results are promising, there’s a lot to consider before giving it a try.

Ketamine therapy is a possible treatment for chronic pain, which is pain that lasts longer than 3 months. While ketamine therapy isn’t typically a first-line treatment, it may be an option if other pain management strategies haven’t worked.

Here’s a closer look at what ketamine therapy for pain management involves, the merging research behind it, and potential risks to consider.

What is ketamine?

While ketamine therapy is a relatively new concept, ketamine has been used for decades. The Food and Drug Administration (FDA) approved it as an anesthetic in 1970. However, the FDA has not approved Trusted Source ketamine for any psychiatric disorder.

The medication acts on N-methyl-D-aspartate (NMDA) receptors in the brain. These receptors operate “channels” that are like switches.

Normally, a neurotransmitter called glutamate switches the NMDA receptor to the “on” position. Glutamate has excitatory effects on the brain and body, meaning it makes you feel more alert and awake.

Ketamine is an antagonist of the NMDA receptor. That means it keeps things like glutamate from activating the NMDA receptor.

When ketamine occupies the receptor, you start to feel sleepy, rather than alert and awake. That’s why ketamine has traditionally been used as an anesthetic.

How ketamine therapy might help with pain

In addition to the effects mentioned above, experts have uncovered other ketamine effects that suggest it may help with pain management:

In higher doses, ketamine can work on opioid receptors. Activating these receptors can help reduce pain sensations.

Ketamine can block some sodium and potassium channels, which is similar to what local anesthetics do.

Ketamine can help increase the amount of gamma-aminobutyric acid A (GABA) in the brain. GABA is the opposite of glutamate. It causes the brain to experience relaxed, slowed-down sensations.

While experts are still learning about the potential benefits (and downsides) of using ketamine therapy for chronic pain, it may be recommended if other treatments, like opioids or nonsteroidal anti-inflammatory medications, aren’t working.

Ketamine therapy is most commonly used for the following types of pain:

• Neuropathic pain: This refers to pain that affects the nerves, which can cause shooting, tingling, or burning pain.
• Complex regional pain syndrome (CRPS), type I: This pain syndrome most commonly occurs after surgery or injury and causes chronic pain.

Ketamine therapy for chronic pain likely won’t work for every person. Finding the right people who experience unique pain types that respond to ketamine therapy is integral to helping people find pain relief.

What does ketamine therapy involve?

Clinics that administer ketamine for chronic pain will usually give the medication via an intravenous (IV) line. Usually, treatment begins with a low dose, and clinicians may increase the dose over time.

Ketamine infusion dosages are usually 0.5 to 2 milligrams per kilogram of body weight over the course of 1 hour when administered for chronic pain.

However, ketamine can be given via injection or even inhaled. The options available to you will depend on your location and what your care team thinks will be most beneficial for your symptoms.