InHealth: Ketamine For Pain Management

By Steven Reichbach, MD

In the U.S. over 100 million people reportedly suffer from some form of chronic pain. Most people can relate to having experienced physi­cal pain in their lifetimes, but to have to live with that pain on a daily basis can become intolerable. Neuropathic pain syndromes are the root cause of many individuals’ chronic discomfort. Neuro­pathic pain syndromes are related to disorders like diabetes, fibromyalgia, CRPS, Lyme disease and migraines to name a few. 

The most common treatment for neuropathy is to mask it with narcotic prescription pain medica­tions. Narcotics like opioids are highly addictive, and our state is currently leading the country in abusing the drug and overdose episodes. The CDC reports that nearly half of all opioid-related deaths are due to the narcotic being prescribed for pain­ related circumstances. 

Pain medications have adverse side effects and also, in many cases, show signs of cognitive decline in long-term use. The other issue with standard pain medication is that they, more often than not, become ineffective and are unable to mask the pain signals. This is called treatment resistance. 

Opioids fool the body by binding to the opioid receptors in the brain, spine and other areas of the body. They DON’T treat the health condition; they merely mask the pain by disrupting the signals to the brain. Opioids are one of the most highly addictive classes of drugs available. 

One of the most promising alternative methods is Ketamine IV therapy.

How does Ketamine Work? 

Ketamine is an NMDA receptor antagonist. Through this mechanism, it is able to modulate the neurotransmitter glutamate. This in turn leads to a cascade of events which can allow for “hardwire” changes in the brain which may result in lifting of depression, reductions in anxiety as well as improvements in other mood disorders. It also allows for a “resetting” of the pathways responsible for Central pain, which is a large component of chronic pain in many patients.

A recent study conducted at Thomas Jefferson Uni­versity Hospital involved 61 patients with intrac­table migraines. Of the 61 patients in the study, 75% showed a decrease in the intensity of their headaches after receiving low dose IV Ketamine infusions over five days. On a scale of 0 to 10 (10 being the highest), the self-reported pain score from patients was on average 7.5 before the initia­tion of the study and 3.4 at the conclusion of the IV Ketamine infusions. 

IV Ketamine is currently used to help treat neuro­pathic pain syndromes such as CRPS, fibromyal­gia, trigeminal neuralgia, migraines, and herpetic neuralgias. There is a growing body of evidence to support that it may have long-term effects for pain relief. 

In recent FDA and other professional associated studies, patient results with ketamine show:

• Reduced pain
• Decreased depression
• Diminished suicidal thoughts and episodes
• Rapid ability to reverse depression and its symptoms

How is Ketamine Administered? 

In our office, Ketamine is administered intravenously. The initial series of infusions are completed over a one week period for pain and over a two week period for mental health and mood disorders.

Ketamine IV therapy impacts pain relief, mood, and anxiety and can result in positive treatment outcomes for the following disorders:

• Severe or Chronic Depression
• Chronic Pain
• Bipolar Disorder
• Obsessive Compulsive Disorder (OCD)
• Post-Partum Depression (PPD)
• Post-Traumatic Stress Disorder (PTSD)
• Produces Rapid Onset of Neural Connections

With our ongoing drug-related epidemic, ketamine therapy can reduce the risk of opioids, benzodiaz­epines, and other narcotic addictions. Physicians are often overprescribing these types of highly addictive drugs to help minimize or mask patient’s chronic pain, depression or other ailments. With Ketamine therapy, the treatment is safe, non-habit forming and highly effective.  

Steven Reichbach, MD
Board-Certified Anesthe­siologist
Gulf Coast Ketamine Center
2415 University Parkway, Building #3, Suite 215
941.213.4444
www.findpainrelief.com.