Ketamine Infusions for Chronic Pain and Mood Disorders
What is Ketamine?
Ketamine is an anesthetic agent that has been in use for over 50 years. At low doses, it can reduce pain by blocking NMDA receptors, which transmit pain signals in the brain. When this receptor is blocked during a ketamine infusion, it can be “reset” or “rebooted”, and the cycle of pain signalling is interrupted. Ketamine can also block other nerve pathways that play a role in opioid tolerance, hyperalgesia, inflammation and neuropathic pain. There is also evidence to support ketamine’s efficacy for treatment resistant depression, suicidal ideation and other mood disorders that have failed other treatment modalities.
What types of medical conditions can be treated?
Some examples of pain that can be treated with ketamine infusions include: phantom limb pain, migraine headaches, complex regional pain syndrome (CRPS), chronic widespread pain syndrome with central sensitization, traumatic spinal cord injury, post-herpetic neuralgia, opioid-induced hyperalgesia. Some examples of mood disorders that can be treated include treatment resistant depression, bipolar disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), alcohol use disorder. Guidelines regarding use and evidence of ketamine for mental health conditions are provided by CANMAT (Canadian Mood & Anxiety Disorders) & KATA in association with CPSBC (College of Physicians & Surgeons of BC).
Potential Side Effects:
(>95% of side effects are short-lived and resolve once the treatment is discontinued)
- Increased blood pressure and heart rate
- Hallucinations, dysphoria, agitation, “out of body” experience, euphoria, nightmares or bizarre dreams, sedation
- Dizziness, blurred vision, nausea, headache
- Psychosis, unmanaged bipolar disorder or schizophrenia
- Active substance use disorder
- Uncontrolled hypertension
- Unstable angina or severe coronary artery disease
- Severe liver disease
What you can expect:
When you arrive for each treatment, you will fill out a few surveys. Then an IV will be placed in your hand or arm, and standard blood pressure, heart rate and breathing monitors will be placed on you. There will always be a nurse monitoring you during your infusion, and a doctor is available if there are any issues or if you are having any concerns. It is normal to feel a bit sedated, dizzy or “out of it” during your infusion. It can be stopped at any point should you wish. An initial ketamine infusion treatment course at KOPI typically starts with 2 treatments per week for 3 weeks (6 treatments total).
You will usually be scheduled for a follow up appointment after your second infusion and sixth infusion, with further appointments booked as required. You may or may not require further maintenance treatment courses in future, depending on your response to treatment and your insurance coverage.
To refer yourself or a patient to KOPI's Ketamine Clinic please download the form above, to be filled out by your primary care physician or psychiatrist. Patients referrals that are accepted to our program will be contacted to fill out our intake questionnaires. Once it is completed patients can go through a medication review and consultation with either our pain specialist or in house psychiatrist Dr. Pikard.