Monday, 15 January 2018

Is Ketamine The Answer To Controlling Nerve Pain?

Today's short post from (see link below) looks at the potential of ketamine in solving chronic pain problems (including nerve pain). Now ketamine, just like methadon, is already quietly, quite widely prescribed for neuropathy pain suppression but that doesn't mean that it's included in the list of standard nerve pain treatments. However, because of the nature of how the drug works, it has been proven to be a successful treatment for stubborn and drug resistant chronic pain. You can ignore the prices quoted in this article; in many countries, ketamine should be available free or be covered by insurance policies. This article is basically an advertisement for the doctor's own practice.The problem is (just as with methadon) ketamine has an image problem and is lumped alongside opioids as being a recreational and easily abused drug that features on many black market lists. Medically, this bad rap is totally unjustified and if you look at the science behind its workings, it has every right to be seen as a potentially effective drug for severe nerve pain. The current climate means that ketamine, methadon and others will face a hostile reception from the medical authorities but if all else has failed, it would be worthwhile talking to your medical specialists about the possibility of it being prescribed. However, first do plenty of  your own research on reputable medical sites; you may be surprised at what you learn.

The Renaissance of Ketamine for the Treatment of Chronic Pain
Posted on January 13, 2018 in Pain Medication By Ed Coghlan.

Dr. Adam C. Young, MD is the Director, Acute Pain Service and Assistant Professor for Anesthesiology & Interventional Pain Medicine at Rush University Medical Center. Recently he agreed to share his thoughts with the National Pain Report on the use of ketamine for the treatment of chronic pain.

National Pain Report: “Ketamine has been around for a long time, and yet it seems to have a new momentum in helping treat some elements of chronic pain. What’s new in 2018?”

Adam C. Young, MD

Dr. Young: “Indeed, ketamine is an old drug that has seemed to found new meaning in the past 2 decades. One of the reasons is published evidence of the utility of ketamine in the operative setting has shown to have promising results in reducing acute (short-term) and chronic (long-term) pain. Another is the current crisis known as the ‘opioid epidemic.’ Ketamine is known to possess properties that reduce tolerance to opioid medications, provide pain relief via other mechanisms, and provide effects that can be long-lasting. As the dangers of chronic opioid use have become better understood, physicians are suggesting ketamine to patients for these reasons.”

National Pain Report: “Obviously, every patient case is a little different. What do you recommend a patient who hasn’t tried ketamine do, in terms of educating one’s self, talking with a physician, how often to have the treatments etc.?”

Dr. Young: “Discussing the nature of a ketamine treatment with your physician is essential. Ketamine is administered typically as an intravenous infusion. Beyond that the duration of treatment, dose of treatment, and number or treatments can vary from one physician to another. Talk to your physician regarding the dose- how they determine it and if there are changes to it throughout treatment. Ask about how long infusions last and how often they are performed. Repeat infusions are fairly common and there may be a benefit to doing so at short intervals as a series. You should ask your physician about other medications that are given during the infusion. In my practice we administer medications to blunt some of the side effects of ketamine in order to make the infusion better tolerated and provide the patient with a better experience overall.”

National Pain Report: “What are the side effects you warn patients of when discussing ketamine treatment with them?”

Dr. Young: “Ketamine is a good drug, despite some of the aforementioned benefits it does have side effects which can be particularly bothersome. Common side effects include nausea, vomiting, increased saliva production, and vivid dreams. Ketamine is also known as a dissociative anesthetic, meaning it induces a trance-like state where patients can maintain consciousness but have an inability to move. There have been cases where patients can hallucinate or experience dysphoria, an unpleasant state of consciousness.”

National Pain Report: “How much does a treatment cost?”

Dr. Young: “Costs vary from office to office and have a wide range. I can only share what my office charges, which is roughly $1000 per treatment. I administer ketamine in a series of 3 infusions, on consecutive days. If a patient proceeds with all three it is roughly $3000 for the entire series.”

National Pain Report: “Looking forward to 2018, what do you think should occur regarding the use of ketamine for chronic pain?”

Dr. Young: “I wholeheartedly believe in the utility of ketamine as an adjunct in the treatment of chronic pain. The United States’ opioid epidemic has underscored the need to treat pain without opioids- ketamine gives us a viable option to do so. Pain physicians have embraced the use of ketamine given its spectrum of benefits with tolerable side effects. We have seen chronic pain patient improve, wean or stop stronger oral pain medications, and see improvements in mood. The medical literature is catching up with our clinical experience; I hope this will encourage insurance carriers to cover this treatment in the future.”

National Pain Report: “Thanks, Dr. Young.”

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