NMDA receptor antagonist that is usually used in anesthesia in humans and animals. Often delivered as an infusion or intramuscularly, or as a cream or gel (often in combination with other analgesics), Ketamine is effective, at least in the short term, in treating several chronic pain states including complex regional pain syndrome and fibromyalgia as well as difficult to treat cases of depression.
The Use of Ketamine for Fibromyalgia
In a CBS News segment focusing on fibromyalgia and its impact, Dr. Ashraf Hanna, a board certified physician and director of pain management at the Florida Spine Institute , Florida, described using intravenous ketamine to successfully treat the disease.
There has been a lot of debate on what Fibromyalgia actually is or how to classify it and because of this, effective treatment options are difficult to find. Also, Fibromyalgia symptoms are subjective and everyone who suffers from Fibromyalgia experiences different symptoms and levels of pain which can vary from day to day, and people can also react to medications differently. Some have said Fibromyalgia is a muscular condition which seems appropriate as many who suffer from this debilitating condition suffer with moderate to severe pain in their muscles.
It also has been classified as a rheumatoid type condition which also makes sense because many suffer with pain in some or all of their joints. However, most of the information out there now seems to indicate that Fibromyalgia may be a nerve condition or Neuro-inflammation in the brain which causes a disturbance in how the brain processes pain and sensory information.
Some studies have suggested that the brain releases toxic type chemicals that are picked up by neurotransmitters and sent to the nerves and other organ systems causing increased pain sensations and neuropathy type pain, and along with that some people are also diagnosed with small fiber neuropathy which can be verified with a skin biopsy.
This does not mean that people with fibromyalgia have more pain; it’s that they experience pain differently and more significantly than other people as well as having a higher sensitivity to certain things such as light, sound, or smell. So what does this mean for treating Fibromyalgia?
Some doctors are now prescribing Ketamine infusions to treat the pain of Fibromyalgia. But what is Ketamine and how does this relate to treatment of Fibromyalgia? Ketamine is an NMDA receptor agonist and also works on opioid receptors in the brain. Ketamine was once used to start and maintain anesthesia and is classified as a disassociated anesthetic. Dissociative anesthesia works in such a way that pain is not recognized by the brain so to speak. So how will this work for Fibromyalgia patients?
Ketamine blocks the receptors that cause the release of the toxic chemicals that cause the reactions in the nerve cells so the pain signals cannot be transmitted to the rest of the body therefore essentially blocking the pain from being recognized in the body. Ketamine is being used more and more in the treatment of chronic pain conditions including Fibromyalgia.
This medication is given to a patient through an IV infusion over a 4 hour time period and doses used are much lower than the doses that were used with anesthesia. How long the medication lasts is different for every patient. A patient’s response to this treatment is as varied as it is with any other treatment currently available.
In some of the information available online, some patients who receive these infusions have reported a 2-3 month period of time with improved symptoms while others have reported more than 6 months relief, and yet others reported shorter than a 2 week period of relief from fibromyalgia symptoms. Doctors also continue with the use of physical therapy, psychotherapy and other medication therapies in addition to the Ketamine infusions. The information available regarding Ketamine infusions and its success varies as well but as with any currently approved treatments for Fibromyalgia, it is different for everyone.
But as everyone who suffers from this condition, and has had no success with any other treatment knows, it’s certainly worth a conversations with your doctor about the pro and cons of this therapy. If your doctor is not familiar with the use of Ketamine, you can work with them to help you find someone who is more knowledgeable about this medication and use for Fibromyalgia.