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Clinical experience with oral ketamine.
M C Enarson1, H Hays, M A Woodroffe
1Department of Family Medicine, University of Alberta, Edmonton, Canada.
Journal of Pain and Symptom Management
|June 4, 1999
Summary
Oral ketamine shows potential for chronic neuropathic pain relief, though side effects limit use for some. Long-term benefits were observed in a subset of patients, particularly those with shorter pain durations.
Area of Science:
- Pharmacology
- Neurology
- Pain Management
Background:
- Ketamine, a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, is increasingly explored for analgesia.
- Chronic neuropathic pain presents a significant therapeutic challenge, often requiring novel treatment approaches.
Purpose of the Study:
- To evaluate the analgesic efficacy and side effect profile of oral ketamine in patients with chronic neuropathic pain.
- To identify patient characteristics that may predict response to oral ketamine therapy.
Main Methods:
- Retrospective chart review of 21 patients with chronic neuropathic pain treated with oral ketamine.
- Dosing started at 100 mg/day, titrated upwards based on efficacy or side effects.
- Analysis of treatment outcomes, including pain relief, side effects, and duration of use.
Main Results:
- Nine patients discontinued ketamine due to intolerable side effects.
- Four patients experienced no discernible pain relief.
- Four patients continued long-term oral ketamine use (over 1 year) with reported pain improvement and reduced analgesic use, particularly those with pain histories under 5 years.
Conclusions:
- Oral ketamine offers potential benefits for chronic neuropathic pain, but tolerability and efficacy vary significantly among patients.
- Further research is warranted to optimize ketamine dosing and patient selection for chronic pain management.
- The duration of pain history may influence the effectiveness of oral ketamine for analgesia.