Ketamine Therapy for Pain and Depression

Low-dose Ketamine Therapy

Ketamine, discovered in the early 1960s, is an anesthetic drug that has been used since about 1970 in both human and veterinary clinical applications. For a number of reasons, including the emergence of newer drugs for anesthesia, the use of ketamine as an anesthetic declined. However, due to its unique properties and newly discovered clinical uses, ketamine is increasingly being used for treatment of chronic pain and depression.

Management of Chronic Pain

Ketamine is leading edge medicine for the management of chronic pain. It functions as a strong NMDA receptor antagonist that eliminates pain hypersensitivity in patients with neuropathic pain and several other types of chronic pain.

Ketamine works by blocking the nerve channels that cause intense pain while allowing the nerves themselves to function normally. It has proven effective in relieving both neuropathic pain as well as other types of chronic pain.

Neuropathic pain is pain that results from damaged nerve fibers and presents as shooting and burning pain, tingling and numbness. Some common causes of neuropathic pain include:

  • Alcoholism
  • Amputation
  • Back, leg, neck, and hip problems
  • Chemotherapy
  • Diabetes
  • Facial nerve problems
  • HIV infection or AIDS
  • Multiple sclerosis
  • Shingles
  • Spine surgery

Other types of chronic pain include:

  • Somatic pain—dull and aching pain present in the skin, tissue or muscles
  • Visceral pain—dull and aching pain associated with the internal organs

Another type of pain that may be managed by ketamine is postoperative pain, for which low doses of ketamine reduce the use of morphine and result in less nausea and vomiting after surgery.

While several NMDA antagonists are available today, ketamine is considered to be stronger than the others. Ketamine is associated with such side effects as drowsiness, dizziness, dissociative feelings, and even hallucinations, so it must be administered at low doses under the supervision of a qualified physician. When used for treatment of chronic pain, ketamine is administered in three-hour sessions for five consecutive days, mimicking the protocols used for inpatient pain management.

Ketamine is delivered via intravenous infusion. It is safely administered in low doses by SIR’s anesthesiologists who are board-certified in both anesthesiology and pain medicine by the American Board of Anesthesiology. They have demonstrated knowledge and clinical judgment in the diagnosis and treatment of all pain disorders, specifically:

  • The principles of pain medicine
  • The anatomical and physiological basis of pain perception
  • The psychological factors that modify the pain experience1

          1 The American Board of Anesthesiology

SIR’s anesthesiologists adhere to strict protocols set forth by academically renowned Wake Forest University, and they evaluate patients interested in receiving ketamine therapy per these protocols to determine if they are viable candidates.

In recent years, clinics have opened up across the country for the sole function of distributing ketamine for pain relief, and it is becoming a lucrative business. Sarasota Interventional Radiology (SIR), headed by Gerald E. Grubbs, MD, board-certified and fellowship-trained pain management specialist, is not one of those clinics but rather is a professionally owned and operated medical facility. Established in 2003, SIR uses advanced technology for unparalleled diagnosis and treatment of many diseases and offers the latest in minimally invasive procedures that meet the highest standards for exceptional clinical quality, cost efficiency, and patient satisfaction. SIR may offer other pain-relieving treatment options in the event that ketamine is not appropriate therapy for a particular patient.

Treatment for Depression

Depression, officially termed clinical depression or depressive disorder, is a real illness that interferes with daily life and normal functioning. Contrary to the belief that some hold, depression is not a character flaw or personal weakness that can be overcome by “snapping out of it” or “getting over it.”  Many factors contribute to depression, including genetics, brain chemistry, medical illnesses, life events, and relationship issues. Clinical depression usually requires treatment by a physician, psychologist, or psychiatrist.

Standard therapies to treat depression include prescribed antidepressants and/or psychotherapy (cognitive-behavioral therapy, interpersonal therapy, and problem-solving therapy). These are important and viable therapies that can improve even the most severe cases of depression, especially when treated early. In some cases of clinically diagnosed depression, however, standard therapies alone may not work. In these cases, ketamine is an additional therapy that may result in significant improvement.

Ketamine is an anesthetic drug that has been shown to be effective in patients who suffer from depressive conditions, including:

  • Anxiety
  • Bipolar Depression
  • OCD (Obsessive Compulsive Disorder)
  • PTSD (Posttraumatic Stress Disorder)
  • Postpartum Depression
  • Severe or Unipolar Depression
  • Suicidal Thoughts

Ketamine as treatment for depression and mood disorders has been on the rise, particularly at ketamine clinics that are increasing in numbers across the country. Sarasota Interventional Radiology (SIR) is not one of these pop-up clinics, but rather is a state-of-the-art outpatient medical facility established in 2003. At SIR, ketamine is safely administered in low doses by SIR’s board-certified anesthesiologists who adhere to strict protocols established by academically renowned Wake Forest University and follow the consensus statement guidance on ketamine use issued on March 1, 2017, by medical experts in the field of psychiatry.

Ketamine is generally administered in four to five sessions over a ten-day period, each session lasting about one hour. Patients receiving ketamine may realize some improvement within 24 hours. Ketamine treatments last for about six months, after which booster sessions are recommended. Although ketamine is extremely low risk, it occasionally results in mild side effects that resolve quickly.