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Ketamine for Refractory Headache: A Retrospective Analysis.

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Ketamine infusions provided short-term pain relief for 77% of patients with chronic, refractory headaches. While many experienced mild side effects, sustained pain improvement was seen in about 40% of participants.

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Area of Science:

  • Neurology
  • Pain Medicine
  • Pharmacology

Background:

  • Chronic headache disorders represent a significant health burden in the United States.
  • Treatment-refractory cases pose a particular clinical challenge.
  • Ketamine, an N-methyl-D-aspartate antagonist, shows promise for chronic pain management.

Purpose of the Study:

  • To evaluate the efficacy of continuous intravenous ketamine therapy for refractory chronic headache disorders.
  • To determine the responder rate and characteristics of ketamine infusions in this patient population.

Main Methods:

  • Retrospective analysis of 61 patients receiving 5-day continuous intravenous ketamine therapy.
  • Defined immediate responders as those with a ≥2-point reduction in pain rating.
  • Assessed sustained response at 1 and 2 follow-up visits, monitoring pain and adverse events daily.

Main Results:

  • 77% of patients (48/61) were immediate responders to ketamine therapy.
  • Maximum pain improvement occurred at a mean of 4.56 days.
  • Sustained response was observed in 40% at 38 days and 39% at 101 days; adverse events were mild and equally distributed.

Conclusions:

  • Continuous intravenous ketamine offers short-term analgesia for many patients with refractory chronic headaches.
  • Adverse events were generally mild and tolerable.
  • Further prospective studies are needed to confirm efficacy and identify specific responder characteristics.