Intranasal Ketamine: A Potential Game-Changer for Your Chronic Migraine

If you are struggling with chronic, refractory migraine and finding no relief from other medications, there is promising news. Recent research suggests that intranasal (IN) ketamine could be a feasible alternative treatment for you.

The Promise of IN Ketamine

In a recent retrospective cohort study, half of the participants who used IN ketamine reported it as “very effective” for their chronic migraines. Over a third of these participants even said it improved their quality of life significantly.

According to the lead investigator, even a few uses of IN ketamine per day can improve your quality of life, especially if multiple medications have failed you in the past.

Exploring New Frontiers

Although ketamine has been studied in patients with cluster headaches and migraines, its use for chronic, treatment-refractory migraines has not been thoroughly explored yet. To further understand its effects, investigators analyzed electronic health records of patients who had received IN ketamine for migraines between January 2019 and February 2020.

Here is what they found:

• Most patients had daily migraines and had tried more than three classes of preventive medications.
• On average, patients used six sprays per day for about 10 days per month, with pain relief typically occurring 52 minutes after dosage.
• Nearly 75% reported at least one side effect, most commonly fatigue, double/blurred vision, and confusion/dissociation. However, these effects were mostly temporary.

A Word of Caution

While the results are promising, it is important to remember that ketamine has the potential to become addictive. Therefore, clinicians should only consider its use for significantly disabled migraine patients.

Patient Experiences with IN Ketamine

About half of the participants found IN ketamine “very effective,” and 40% found it “somewhat effective.” In terms of its impact on their quality of life, 36% and 43% reported it as much better and somewhat better, respectively. Nearly 75% reported using fewer pain relievers when using IN ketamine.

Future Research Directions

Future research might focus on finding predictors for IN ketamine response or determining the optimal effective and safe dose for you if you are suffering from chronic, treatment-refractory migraine. As the lead investigator suggests, a prospective, randomized controlled trial is needed to assess the efficacy and tolerability of IN ketamine.

Expert Opinions

Experts agree that the results are impressive, especially for a population with multiple treatment failures. They believe that ketamine could be an effective option for people with medically intractable chronic migraine. However, they also highlight the need for well-designed placebo-controlled trials and rigorous comparative effectiveness studies.

A Promising Path Forward

This study offers hope for those suffering from chronic migraines. While more research is needed, the results suggest that IN ketamine could become a valuable tool in your fight against this debilitating condition. As always, it is important to discuss any potential new treatments with your healthcare provider.