Ketamine for Migraine Management

Imagine being transported to a place where you felt no pain. You may have an almost out-of-body experience that is peaceful and comforting. New thoughts and revelations may enter your mind as you bask in an instantaneous pain relieving world. Sounds kinda trippy, right? Some of you may be flashbacking to drug experimentation of your youth with hallucinogenic drugs. The cause of this seemingly blissful state, is not far off from those free-loving days of the 1970s…or even the euphoric and happy effects of popular rave drugs today like ecstasy. This pain-free place has been created by Ketamine and it could be used to help YOU, a Chronic Migraine sufferer.

If you’re not familiar with Ketamine, maybe you’ve heard it referred to as “Special K”, “Ket” or simply “K” when abused as a recreational drug. Still not sure? In its intended form, it is used as a horse tranquilizer by veterinarians or by anesthesiologists to knock out a patient undergoing surgery. So how does this potent drug come into play for Chronic Migraineurs?

Over the last few decades, Ketamine has been studied and tested on patients with various pain ailments. Dosing is considerably smaller than that used in a surgical setting and less than what a drug user would take in order to be transported into the “K Hole,” (The K Hole references the deep hallucinogenic state that creates feelings of extreme disassociation when used at high levels). Ketamine is an NMDA antagonist. It blocks a glutamate chemical in the brain and causes brain cells to form new connections.7 While the reasons why Ketamine works to relieve pain are still largely unknown, studies have shown that it can be used as part of a pain management program as it is less addictive than standard opioid therapies.

History

  • Ketamine was discovered in 1962 by pharmacist Calvin Stevens6. It has widely been used as an anesthetic for humans and large animals undergoing surgery.
  • In the 1970s, Ketamine was being used as a recreational drug, which induces hallucinations and other psychotropic effects when taken in smaller doses than used for surgery. Effects of Ketamine as a recreational drug are similar to use of LSD, PCP and Angel Dust.
  • Ketamine can be found in pill form, powder, IV infusion, intra-muscular injection and intranasal spray. Ketamine is a Schedule III drug.
  • John Lilly, a neuroscientist who was a pioneer in researching early dolphin-to-human communication and dolphin intelligence, experimented with Ketamine to cure his own Migraine headaches. His fellow researcher suggested using Ketamine in the sensory deprivation floating tank Lilly had created. Three different doses of Ketamine were injected before long term relief from the Migraine occurred. Consistent doses of Ketamine seemed to prevent future Migraine attacks5 of Dr. Lilly.

Studies

Dr. Carlos Zarate, a Chief researcher at the National Institute of Mental Health, says that “we can take care of a migraine in hours” using ketamine7. Dr. Zarate is mainly focused on using Ketamine for treating major depressive disorders, however there have been several studies geared toward treating Migraines.

One study tested the effects of intranasal Ketamine on 11 patients with familial hemiplegic migraines. Under supervision, each participant was given a 25 mg dose via a nasal spray at the onset of a Migraine attack. They were asked to record their symptoms 15 minutes after each use and were then allowed to administer Ketamine at home. During the study, over half of the participants reported an improvement of all of their symptoms after using Ketamine.8

In a separate study, researchers examined the effects of IV Ketamine infusions of participants who were actively having a Migraine attack. Over 159 minutes, participants were given 64 mg of Ketamine through an IV. On a 1-10 pain scale, participants had an average pain score of 6 before treatment. After the Ketamine infusion, the average pain score reduced to 2.5.9

The most promising study was discussed by the late Dr. Andrew Sewell on a Ketamine web forum. 247 patients participated in an open outpatient study that used IV infusions of Ketamine. The participants represented five different types of Migraine sufferers. Every group reported at least a 50% reduction in their headaches.10

  • In 162 patients with Refractory Migraines, 150 reported greater than 50% reduction in their pain.
  • In 39 patients with Chronic Migraine, 26 reported greater than 50% reduction in their pain.
  • In 4 patients with Paroxysmal Hemicrania, all 4 reported complete resolution of their pain for an average of 7 days.
  • In 11 patients with Cluster Headaches, all 11 reported complete resolution of their pain for an average of 6 days.
  • In 31 patients with non-specific headache type and facial pain, 25 patients reported greater than 50% reduction in their pain.

Cons

While these studies are promising, there are still many questions unanswered. Additionally the potential side effects of long term use of Ketamine (either recreationally or for medical use) are still not fully understood. Here are some of the potential side effects:

  • There is a concern that cognition could be permanently impaired after years of use.
  • Bladder issues, such as ulcerative cystitis, have been reported in 20-30% of recreational Ketamine users.1 Often, these symptoms can be reversed after cessation of the drug.
  • Liver damage.
  • Increased blood pressure and heart rate.2
  • Respiratory depression.
  • Cost and access can be prohibitive. Most insurance companies won’t cover Ketamine infusions, which can cost between $300 and $1,000 per infusion.2
  • Recreational uses of Ketamine have been attributed to deaths since its creation. However, cause of death is typically linked to use of additional drugs or alcohol in connection with Ketamine. There have been few recorded cases of patients dying strictly from Ketamine use.6

Other Potential Medical Uses for Ketamine

Studies are currently underway to examine the therapeutic effects of Ketamine for other diseases and illnesses. These include:

  • Ménière’s disease (3).
  • Status Epilepticus (4).
  • Spinal Cord Injuries.
  • Phantom Limb Pain.
  • Refractory Cancer Pain.

Conclusion

The use of Ketamine for medical purposes (other than for anesthesia) is being explored for Migraines as well as many other illnesses. With the risk of addiction lower than using opioids or narcotics, Ketamine could become a more widely used tool in pain management. However, with limited studies, Ketamine treatment for Migraine is not being used as the first line of defense and many Headache Specialists are hesitant to use it.

If your doctor offered you a chance to try Ketamine to manage your Migraines, would you try it?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
  1. https://www.erowid.org/chemicals/ketamine/ketamine_article2.shtml
  2. http://www.nytimes.com/2014/12/10/business/special-k-a-hallucinogen-raises-hopes-and-concerns-as-a-treatment-for-depression.html?_r=0
  3. http://www.nytimes.com/2015/01/10/business/ear-disorders-long-neglected-attract-drug-makers-attention-.html
  4. http://www.independent.co.uk/life-style/health-and-families/health-news/the-women-who-was-saved-by-a-rave-drug-427185.html
  5. http://www.conspiracyarchive.com/UFOs/Gorightly.htm
  6. https://www.erowid.org/chemicals/ketamine/ketamine_timeline.php
  7. http://www.npr.org/blogs/health/2012/01/31/146096540/i-wanted-to-live-new-depression-drugs-offer-hope-for-toughest-cases
  8. file:///C:/Users/Owner/Downloads/Practical_Pain_Management_-_Ask_the_Expert_Intranasal_Ketamine_for_Migraine_Therapy_-_2014-05-30.pdf
  9. http://www.anesthesiologynews.com/ViewArticle.aspx?d_id=2&a_id=10104
  10. http://www.clusterheadaches.com/cb/cgi-bin/yabb2/YaBB.pl?num=1306848738

Comments

View Comments (27)
  • shelleysqrd
    1 year ago

    I had my first ketamine treatments almost 2 weeks ago. I have the type of migraine that never really goes away. It only varies in degree. I had to have mine done on an inpatient basis over 3 days. I woke up on day three with a pain level of 2 and over the next 7 days I was migraine free. I was and still am flabbergasted and on cloud nine. I had last treatment done on the July 21st and returned to work for the first time in over 3 months on July 27th. I’ve had 2 migraines since then that responded to my rescue meds and 1 that started on Friday Aug. 4th that has bit responded to treatment. This one is nit as bad as my previous migraines and I plan on going to work tomorrow. My doctor said to expect to have a booster treatment in 6 months. It’s a start.

  • Cheryle Breaux
    1 year ago

    Was it a neuro that treated you or did you have to go to a pain management specialist? I’m at the end of my rope with daily headaches. I have an appointment with my pcp tomorrow because I need help finding a new headache doctor. I saw my regular neuro last Friday and he had absolutely nothing except a Medrol pack to offer me. I feel like he has never really treated me because he keeps telling me, “well, we can try a Toradol shot or dhe infusion” and I reply, “Tried them and those don’t work for me”. Nothing works anymore so I’m wondering about this ketamine treatment. I don’t think my current neuro would do it because he’s super conservative. He just wants to prescribe triptans and do botox on you and neither of those work anymore. So, I need a doctor who is more cutting edge but I live in Louisiana and our healthcare isn’t the best. Anyway, I’m just wondering if I need to skip the neuro altogether and go straight into pain management. I’ve been dealing with migraines my entire adult life (I’m 51) but they turned daily in 2008 after having sinus surgery. I have a really good job that I’m trying hard to hold onto but this headache is wreaking havoc on my life and I’m afraid I’m going to end up unemployed again if I don’t get some help soon. Didn’t mean to go on so long. I’m just grasping for any ray of hope.

  • Katie M. Golden moderator author
    1 year ago

    @shelleysqrd,
    Thanks so much for sharing your experience. I’m really excited for you! I hope this continues to be an effective treatment. Keep us posted!!
    -Katie
    Migraine.com Team

  • SouthernUtahGal
    2 years ago

    It’s been a while since I posted on this topic last. When I first read about using Ketamine to help treat my Migraine I talked to my Primary Care Dr. He is always willing to listen and help me try new things. After we tried a few different dosages, and I found that it helped with my migraine, I went to my pain clinic. It only helps as an abortive, not as a preventative, for me anyway. I have only tried it in Nasal Spray form, not IV or tablets. Each spray contains 10mg of Ketamine. I use anywhere between 1 and 4 sprays, depending on severity. It’s affects are pretty immediate. It doesn’t actually stop the migraine, but eases the pain tremendously.

  • Katie M. Golden moderator author
    1 year ago

    @Cheryle Breaux,

    I’ve gotten my ketamine treatment from a neurologist who is a headache specialist, which are hard to find. These docs take an extra year of fellowship to learn to treat patients with the over 300 headache disorders that exist. This link will take you to a list of headache specialists by state. It sounds like you should consider making an appt.
    http://migraineresearchfoundation.org/resources/find-a-doctor/doctors-certified-in-headache-medicine/

    My ketamine treatment is done in-patient as a 5-day infusion. My headache specialist leads the team, but the pain management group makes the adjustments to the ketamine levels.

    As far as I know, this is the only place that does an in-patient hospitalization for ketamine. If you can find a pain management doctor, there are places that will do 3-6 hour ketamine infusions, send you home, then you go back for 2-5 days in a row. That may be a quicker route to go to get some relief sooner (if it helps you), but I would still suggest that you try to make an appointment with a headache specialist.

    There’s a facebook group called Ketamine and Chronic Migraine that has a lot of great resources and the majority of patients in the group receive ketamine infusions through a pain management group.

    I hope that helps!
    Best wishes,
    -Katie
    Migraine.com Team

  • hoochie824
    3 years ago

    I have been discussing this with my neuro. Possibly trying the 3 day inpatient infusion. I have tried everything else so its kind of my last hope as I am a chronic daily migraine sufferer.

  • Katie M. Golden moderator author
    3 years ago

    @hoochie824,
    I really hope it helps you. Just be open to the experience and go in with no expectations.
    Let us know how it goes!
    -Katie

  • Amy Williams
    3 years ago

    I would love to try it.

    Anyone know a treatment center that offers it?

  • Katie M. Golden moderator author
    3 years ago

    Amy,
    I started my ketamine treatment at Jefferson University Hospital in Philadelphia.

    You can also try finding a pain clinic that has an anesthesiologist who would administer ketamine for you.

    This link may help you find a doctor in your area that works with ketamine.
    http://batchgeo.com/map/58022147acde40c9fed8f34f17d7d9c4

    -Katie
    Migraine.com

  • Katie M. Golden moderator author
    3 years ago

    @Migraine Man, I couldn’t agree more. There are more studies being down about Ketamine and depression or bipolar than studies on it’s effects on Migraines. If I find a way for us to be heard on this issue, I’ll let you know!
    -Katie
    Migraine.com Moderator

  • Migraine Man
    3 years ago

    Hi Katie,

    Another great post. Hopefully this will get some attention / awareness out there to both doctors and patients regarding the benefits of safely using Ketamine for for treatment of migraine.

  • Jules2dl
    3 years ago

    @Katie Golden: Katie you got ketamine infusions at Jefferson, didn’t you? Were they covered by insurance?
    Many thanks,
    Julie

  • Julie
    4 years ago

    I live in Grand Rapids, MI and when I have asked about this treatment for migraines, I get looks like I am an alien..lol. I have been trying to do research on my own and this article is FANTASTIC. Thank you so much for writing it. I’m going to bring it to my next Dr. appt. and I’m going to put a copy of it in my purse, so the next time I may end up in the e.r., they won’t think I’m completely nuts when I mention Ketamine as something to try. Thanks Katie !!

  • Obitsfan
    4 years ago

    I tried IV Ketamine. It was done in the ICU as it needed to be closely monitored. Sad to say it did not “break” what at the time turned out to be 2 1/2 year migraine. I can’t even tell you what finally did.

  • Mary's head
    4 years ago

    I suffer from migraines and the physical problems of silent migraines. When I am not in pain (which is becoming more electrical) I fell like I have the flu. I have gone from being a successful attorney to being virtually housebound. I am at the point where I will try anything.

    I am scheduled for IV ketamine starting in May. I will have the infusions once a week for four weeks. The doctor is a well known anesthesiologist/pain physician. In the meantime, I am starting nasal ketamine today with my neurologist to see if I can get some relief before the infusions. I will report back. BTW – this is my first post.

  • SouthernUtahGal
    3 years ago

    Can you tell me what the dose/strength is of your Ketamine Nasal Spray? I am just now trying it out, but the dosage seems to be wrong. I’ve tried 2 different strengths so far.

  • KaciMo
    4 years ago

    My doctor prescribed Ketamine nasal spray a couple weeks ago to take as needed, but it didn’t do much for my pain level. Yesterday he switched me to Ketamine tablets to take 3 times a day, starting on a low dose and saying we’ll gradually increase it. I’ll pick it up from the compounding pharmacy this afternoon and start taking it tonight. I’ve read several articles online about intranasal and IV Ketamine, but I haven’t found anything about the oral version. Anybody have experience with this?

  • Luna
    4 years ago

    I remember LSD, PCP and Angel Dust from the 1970’s. Don’t want to return to anything like that.

  • Sean
    4 years ago

    Yes I would, in less than a heartbeat, especially if it worked as a preventive.

  • Melissa
    4 years ago

    I’m chronic migraine… Like 28 days out of 30. And the only 2 great days are immediately after my monthly nerve blocks. I’ve actually been using ketamine nasal spray for about 3 months. I use it for relief from when my daily migraine hits above a 9. One spray works in about 15 minutes, and keeps the pain at bay for about 5 hours, and even then it usually doesn’t come back as strong. I have noticed a bit of a fog in my memory sometimes the next day, like if we watched a TV show after using the nasal spray, I won’t always remember what happened during it. But overall, its been a live saver in times when I might have had to go to the ER. I have to get the rx filled at a compounding pharmacy.

  • ThreeGals
    2 years ago

    I am so happy to hear this! Ketamine nasal spray is being compounded for me. I’ve been fighting my doctor about using it until now. I’ve heard about the high and even hallucinations, and have been very fearful. I do not react well to strong meds. I really hope like crazy this makes a difference. I’m so tired and worn down.

    S

  • Katie M. Golden moderator author
    4 years ago

    Melissa- thanks for sharing. It’s good to know that it’s been helpful for you. I hope that after more clinical studies it will be a more widely used abortive.
    -Katie

  • chienjouet
    4 years ago

    I would absolutely be willing to try this.

  • Katie M. Golden moderator author
    2 years ago

    I’m not sure I answered everyone’s questions, so here’s a few more thoughts and ideas:
    1. @Threegals- yes, ketamine can make you hallucinate, but in a nasal spray form, you would have to take a lot of it to induce those effects. You may feel a little disassociated from your body and surrounding with the nasal spray. Just make sure someone is with you when you try it.
    2. @SouthernUtahGirl- my dose says “10% ketamine,” that’s all I can figure out on the dosing. j
    *I’m not a doctor so this doesn’t mean it will work for you as well!
    @Tanya- If your neuro is not willing to prescribe this, the next step would be to find a pain specialist. They are more willing to use this as part of your pain management.
    @Mary’s Head- how has your experience been with the nasal spray?
    @Jules2dl- insurance has covered my hospital stays. I’ve had issues with getting pre-approved, or with insurance incorrectly billing me after I get out, but in the end (and hours of phone calls later) it has worked out in the end. Just make sure you understand your deductibles and any copays for hospital visits because that will be your responsibility.

    Any other questions!?
    -Katie
    Migraine.com

  • Tanya
    4 years ago

    I would absolutely try this, but how hard would it be to find a doctor who would?

  • Amy Williams
    3 years ago

    Following post

  • ddowlen
    10 months ago

    I hate to say it but I have lost trust in the doctors. I began looking into natural stuff that didn’t make my hair fall out and make me feel crappy from all of the side effects.I found a product that worked for me after 30 years of suffering every single day with a migraine. I consider myself at the extreme end of sufferers. Might be worth a try for some of you and the best part was its all natural (no side effects) and they offered a trail bottle. I read all of these posts on this site and it breaks my heart to know most of you are still miserable. Look them up. It might be your answer. Doctors and meds did NOTHING for me for years!!! The name is URLifeBack and I stand by it. It gave me back my life and I’m grateful. Best of luck to all of you

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