I fondly refer to in-patient hospitalizations at Thomas Jefferson University Hospital in Philadelphia as “Headache Camp.” It makes it sound less scary and more like an experience that I will remember fondly for the rest of my days. Since mid-2013, I have been going to Headache Camp on average of twice a year. During my time at camp, I receive a continuous IV drip of ketamine in an effort to rest my brain, which is constantly firing off pain signals. Since becoming chronic in 2011, ketamine infusions have been the biggest factor in helping me to manage my pain.
To be honest, I probably get two or three questions a week via social media about my experience with ketamine. I’m happy to share my story and answer questions. I want others to explore their options and maybe find some relief. I think I’ve probably jammed up Jefferson’s schedule with the increasing number of people who have read my stories and decided they wanted to try ketamine for themselves.
If you’re not familiar with ketamine, it is a synthetic drug discovered in the 1970s and was used widely as an anesthetic for surgery. Veterinarians also use it as a horse tranquilizer. Special-K is one of the street names for ketamine. People have abused ketamine for decades. So why in the world would anyone in severe pain want to try this drug? We’re desperate to try anything and this seems to work.
The Headache Clinic at Jefferson Hospital offers the ONLY in-patient ketamine infusion for the treatment of chronic migraine. Pain management clinics may offer in-office infusions that last for 4-8 hours a day, which is repeated for several days in a row. The difference is that the patient takes a break and goes home every night. For anyone interested in ketamine, daily infusions are a good alternative.
New Study Results
Ketamine is not a widely used drug for the treatment of migraine, although it is being studied extensively for depression and PTSD. To be honest there haven’t been enough studies to show its efficacy for migraine. It’s also not entirely clear why ketamine provides relief. Since the Headache Clinic at Jefferson has the most experience in administering this drug, they published results in the Dec 2016 edition of Headache, the Journal of Head and Face Pain.[i]
The retroactive study examined the experiences of 77 patients who received ketamine treatments from Jan 20016 through Dec 2014. These patients were either diagnosed with chronic migraine or new daily persistent headache. Those who were chosen to receive ketamine infusions had failed traditional or more aggressive treatments in the past.
Upon admission, the average headache pain was determined to be 7.1 (on a 10-point scale) prior to receiving the ketamine infusion. Patients were then administered 1ml of ketamine per 1kg of their body weight for an average of five days. 71% of patients experienced at least a two-point decrease in head pain. The average head pain at the end of the infusion was 3.8 (on a 10-point scale). 27% reported that their pain level had remained at a lower level during their follow-up visit.
The analysis of these patients suggest that ketamine infusions could be a viable treatment option for those with chronic migraine and new daily persistent headache, however controlled trials are needed to explore treatment efficacy further.
Preparation for receiving a ketamine infusion
As I mentioned previously, I get asked questions quite often about my ketamine experience. Whether you’re receiving an in-patient infusion at Jefferson or getting multiple daily infusions in a pain specialist’s office, there are some key things that I think every patient AND their family needs to understand:
- Ketamine should become an option when aggressive treatments like Botox, nerve blocks, DHE infusions or stimulators have not worked.
- Everyone’s response will be different. Don’t set yourself up for failure by thinking this is the absolute cure for your migraine disease. Consider it a success if the treatment is able to knock your daily pain level down by two or three levels.
- This is a hallucinogenic drug. Go in with an open mind. You are in a safe space. You may close your eyes and see beautiful kaleidoscope patterns or have intense vivid dreams. Enjoy it!
- In my experience, with each ketamine infusion, my body responds more positively. My average pain level decreases for a longer period of time. I can’t promise this will be everyone’s experience. But if your first experience didn’t make a difference, the second or third infusion could eventually make a difference.
- Ketamine will mess with your emotions. I learned this the hard way. I typically feel very sleepy, but upbeat while on ketamine. It kind of feels like you’re drunk (in the best way). After several days, it can mess with your emotions or cause you to have weird thoughts. DON’T keep this to yourself. Tell the nurse right away. There are medications, such as Ativan, that can help to calm you down. Don’t struggle in silence.
- Stay away from social media. There will come a point when you absolutely don’t make any sense. I once emailed friends telling them that if they called me I could read their palm. That’s not how that works.
- Be prepared to need help when you go home. Your body has just gone through an extreme transition. Allow yourself time to heal. Don’t plan any strenuous activities for at least a week after your treatment.
- Lastly, keep a headache diary when you come home. At first you may not feel like anything has changed, but over time the effects could sneak up on you and your daily pain could improve. Keeping records will help you and your doctor to decide if ketamine therapy was worth it.
Finally having a study to reference on the effectiveness of ketamine in chronic migraine patients can open doors for additional studies and potentially more accessibility. Long term studies are still necessary to examine any side effects from years of use. If you have a ketamine story you want to share, please do!