Migraine and Other Disorders

Migraine headache is an episodic, disabling headache associated with nausea and sensitivity to light and/or sound. The headache tends to be throbbing, one -sided, and worse with movement. It is usually preceded by a prodrome (eg, yawning, euphoria, depression, irritability, neck stiffness) and sometime an aura (problems with vision, hearing, speaking, sensation, movement). Triggers include stress, menses, not eating. Migraine affects 17% of women and 6% of men. Treatment consist of analgesics and specific anti-migraine medications (e.g., ergots, triptans, beta- and CGRP blockers). While such therapies may have a partial effect, many still suffer from incomplete treatment. Data on the use of ketamine for severe migraine headache is preliminary, but several case reports and case series have shown a significant reduction in headache pain with ketamine use.

The causes of chronic back pain are numerous: ligament strain, muscle injury, ruptured disc, osteoarthritis of the facet or sacroilliac joints, spine fractures (spondylolysis), spinal stenosis, spinal cord injury, and failed back syndrome. At any one time, severe back pain can be found in as many as 10% of persons, regardless of age, weight, or gender. The exact mechanism of pain may be different in all these conditions. But as case reports and case series suggest, ketamine has the potential to reduce back pain from variety of causes. As long as the cause of the pain has been evaluated and optimized, patients with persistent chronic back pain may be candidates for ketamine therapy.

Several painful gastrointestinal disorders may be amenable to ketamine treatment. For instance, irritable bowel syndrome (IBS) is a disorder of the gastrointestinal tract characterized by cramping, chronic abdominal pain with constipation and/or diarrhea. It is seen in approximately 10-15% of adults and adolescents, mostly female. Crohn's disease (CD) and ulcerative colitis (UC) are the two major inflammatory bowel disorders. CD can involve any portion of the gastrointestinal tract, from mouth to rectum. It usually affects the distal small intestines and sometimes colon. UC, as the name implies, primarily affects the colon. Both can present with abdominal pain and diarrhea that is sometimes bloody. Although the data on the use of ketamine to treat gastrointestinal disorders is limited to individual reports, its ability to treat pain and depression, allay anxiety, and reduce inflammation make it an attractive therapeutic alternative when gastrointestinal pain is refractory to other therapies.

Post-Covid-19 syndrome, COVD long-haulers or long COVID, as it has been called, is a broad range of physical and mental symptoms that develop during or after a COVID-19 infection. Symptoms include fatigue (most common), breathlessness, brain fog, impaired memory, disrupted sleep, and depression. The reported incidence is variable, reported between 15 and 80%. Women are affected more than men. Because these symptoms overlap with those following other infections and critical illness, it remains unclear whether they are unique to COVID-19. However, the mental complaints after COVID-19 are more common that those seen after other illnesses, suggesting a unique disorder actually exists. It remains to be seen whether ketamine can play a role in the recovery of long COVID. However, given its success in treating depression, anxiety, PTSD, chronic pain, and suicidal ideation, a beneficial effect of ketamine seems plausible, if not likely.

The intense analgesic effect of ketamine, along with its ability to reduce anxiety and depression make it an attractive drug to treat a variety of conditions. Although not yet FDA approved, ketamine is used today in pain clinics and hospitals around the world for a variety of severe pain disorders. These include diabetic neuropathy, shingles (post-herpetic neuralgia), peripheral neuropathy, trigeminal neuropathy, temperomandibular joint (TMJ) syndrome, neck and back pain, pelvic pain, bladder pain, endometriosis, vulvodynia, joint and musculoskeletal pain, rheumatoid arthritis, Lyme disease, sickle cell disease, restless leg syndrome, and cancer pain. Some have suggested its use in anorexia nervosa. The precise mechanism of ketamine is unknown, and evidence of effect for most of these conditions is based on individual reports. But for those suffering from severe, refractory pain, ketamine offers new hope for rapid and lasting relief from pain and suffering. 

We believe that mental health is a right and should be available to all. Our IV ketamine treatment for depression starts at $425 for a 1-2 hour, highly personalized session. It is a longer period than that at most other centers, but one we found produces a more robust and long-lasting effect.

Ketamine is not a replacement for accepted treatments from a qualified professional mental health provider. If you or your loved one is interested in ketamine as a supplement or alternative to traditional therapy, please give us a call for a free consultation.