Chronic migraines can be one of the most challenging diseases to treat.Migraines affect 1% of the population in the United States and can be severely debilitating as well as negatively impact the quality of life in those who suffer with them. Medications such as opiods, antidepressants ,antileptics, beta blockers, triptans and non-steroidal anti-inflammatory medications are commonly used to combat these headaches.
As with many other chronic pain illnesses, the incidence of depression, anxiety and other mood disorders is vastly greater than in the general population. For some patients, relaxation training, biofeedback training and stress management can help patients with their headaches. Cognitive behavioral therapy is also frequently used with varying success. More recently, neuromodulator devices such as the Cefaly device have been used to decrease headache days by 50% in some patients. Botox injections can also be used to help mitigate the symptoms of chronic headaches in these patients.
Ketamine is an anesthetic medication that has been shown to be effective in treating many chronic neuropathic pain conditions when given intravenously over a number of days. Ketamine is an NMDA receptor antagonist and regulates the amount of the excitatory neurotransmitter glutamate in the central nervous system. It is this mechanism of action that is thought to decrease the central sensitization and “windup” which occurs in these chronic neuropathic pain syndromes. Applying this information to patients with chronic and intractable headaches has led to the use of Iv ketamine to aid patients still suffering despite having been treated with some or all of the above conventional modes of therapy.
Most of the information is coming out in the form of case reports and case studies. The results have been very positive thus far. While It is impossible to predict how an individual will respond with respect to the degree of improvement of their pain, frequency of headaches, aura and overall duration of improvement, it is becoming clear that Iv ketamine therapy can play an important role in helping to treat these debilitating headaches.
Over the past 6 months, we at GCKC have treated 7 headache patients (4 migraine; 1 cluster; 2 atypical chronic) all of whom had significant improvement in severity and duration of their headaches. The duration of improvement ranged from 5 weeks to at this point 4 months. For patients who have suffered for so long ,this option is becoming more and more welcomed by patients and their families.
Steven Reichbach, MD, Board-Certified Anesthesiologist, specializes in pain management. For more information, please contact their office today at 941-213-4444, or visit their website at findpainrelief.com.
2415 University Parkway, Building #3,
Suite 215, Sarasota, FL 34243