Ketamine Infusion

[nyhotfoot]

Help!! I only have two days to learn as much about Ketamine Infusion as possible.

Traveled from NY to Houston Medical Center to see top Neuro and he is recommending Ketamine Infusion. I'd like to hear from anyone who has had this treatment and will kindly share their experiences.

All info appreciated, Thanks!
nyhotfoot

[Silverlady]

Just a brief question. Why did you go to Houston, when Johns Hopkins, Mayo are closer to you?

Billye

[nyhotfoot]

My dearest friend has been at Methodist Hospital for five months following an experimental treatment for liver cancer (stage 4 breat cancer). I went there to support her. The added activity caused my PN to really flair up and I was hobbling outside the hospital when I came up on a patient sitting outside having a cigarette who asked why I was limping. As it turned out, she was there for polyneuropathy and highly recommended Dr. Everton Edmonson, Neurologist, Neuro Oncologist, and Pain Management Specialist. She flies there from Colorado to see him. Before I knew it, three other patients there told me about him, I saw it as a sign.

I had previously seen three neuro's who offered no treatment options and no hope. I have a super pain mgmt team but still have to beg for adequate pain meds. How could I not at least hear what he had to offer?

Ketamine Infusion has been a standard treatment in Canada for years, but because it causes similar effects of LSD (hallucinations, paranoia, "trip effect"), the medical community has been reluctant to adopt it here.

What I was told is that the treatment will be done in a recovery room type setting. The IV infusion takes approx 30 minutes, then I'll stay for observation for 45 min. to an hour while I "trip". The long term benefit (one week to one month) is pain suppression and a detox effect, where it breaks down the tolerence to opiate meds and they can lower the doses that have been raised over the years.

I contacted my pain group in new york and they are very interested in the outcome. They may be willing to administer if I get a good result, and depending on how it goes over the next year, may offer it to other PN patients.

It must really be cutting edge since no one has responded with their own stories.
As a side note, why the interest on the location and not the treatment?

[Silverlady]

I live in Texas and am planning a trip to Mayo in Dec. I just wondered what Houston had to offer since I had not found anything in the Dallas area that helped. I'm still waiting on diagnosis. The neuro "thinks" it's small fiber neuropathy and pudendal neuropathy caused by Sjogrens syndrome. But no way to prove it in this part of the country. Mayo has the small fiber skin tests. That is my main reason for going. And to see if they can offer me something in the way of pain control and to slow down the progression of this disease. I'll be interested to see how you come out in case I come home with no solution to the pain.

Billye

[janster]

Don't want to hijack the thread, but.....

...... I live in Texas and am planning a trip to Mayo in Dec......And to see if they can offer me something in the way of pain control and to slow down the progression of this disease.
Hi Billye~
If you're talking Mayo in Rochester, MN, I can tell you what they offer in the way of pain control. You will be sent to their pain rehab clinic. That consists of 15-18 days of out-patient, 8 hours/day teaching you how to live with your pain. You can call for information.

They will want to take your meds away so you won't be dependent on them, but they will teach you other ways of living without them. They use biofeedback, psychiatrists, physicial therapy etc.

I was just at a Dr. appt last week and happened to talk to a man who was going through their clinic. He reinforced what the information said. They were taking away his meds. The part that blew me away while talking to him was that they wouldn't let him limp or rub his sore leg when it hurt. They do not want him to limp or favor his "bad" leg as he said. I asked him why he couldn't rub his leg when it hurt and he said that it drew his attention to it then.

I am not knocking Mayo's Pain Rehab Clinic. I am relaying information that was sent to me (personally said to me) when all of my doctors told me last year that was my next step. (Neurologist, Psysiatrist, Anesthesiologist) I called for information.

I don't know if you remember reading the CP board about this way back when, but I told them I couldn't afford to do this. (I did not mention the name of the clinic) My Neuro, who I had to beg to get just Tramadol from (Mayo does not believe in prescribing Narcotics) did not refill it until I called her, next to tears, and explained that when I went on Medicare next year I would go through their pain rehab clinic. She then refilled it for 2 months.

I wish you good luck in whatever you decide Billye. Let me know how you turn out.
Hugs,
Jan

[dahlek]

Was that why Mayo was bumped down and Hopkins took the lead for this past year? I really, thought they [Mayo] would have been a teeny bit more 'progressive' as it is put towards the narcotics. They are now, sending VERY VERY mixed signals. An I can bet folks would stay away in DROVES if seeking pain control for neuro issues from MAYO. Especially in light of all the papers published from same source endorsing narcotics..w/temperance for pain issues ALBIET From their research centers..[usually on rats] These are times I wish I were one?.

Whatever your path, I sure hope the actual docs you get to 'test/examine' you actually have independent thinking brains in their heads. Heaven knows, we sure need them everywhere and soon for all of us...


Billye, especially for YOU ! - Good hugs, thoughts and fuzzies to all. - j

NY HOt...wow, I can't believe how many c or c contacts or connections I find.. I know for sure, that so many others in the med morass read our posts and looove feedback. Believe me, IF I really thought any treatments could be changed or be mroe progressive..Well I would proceed to butt my head against any wall I needed to to GET IT! I can be a trifle assertive in terms of what could only be explained well as 'MEIAOW!' I am trained, BTW.

Nice things for you all today - j

[Silverlady]

I'm not going to Mayo for pain control. I have a good doctor who will prescribe whatever it takes. I don't take anything but a tiny dose of Trammadol at bedtime and Lyrica for the neuropathy. I can't stand anything that is drying. (severe dry eyes and mouth) But I would hope that Mayo offers something in the way of treatment options for a neuropathy that is advancing rapidly. I just really need a diagnosis that insurance will buy.

Thanks for the information tho, I will keep it in mind while at Mayo. I had read on another link that Mayo was opiod-phobic.

Billye

[janster]

Thanks for the information tho, I will keep it in mind while at Mayo.
You're very welcome. Sorry for the late answer--just got home, again, and if you're there tomorrow, lunch is on me. :(
Hugs,
Jan
PS--(Inside information) Stay at the Microtel North. (if there is more than one) Clean rooms, Mayo discount, excellent FREE breakfast! That's where I stay when I need to do the overnights.

[lucindamw]

NYhotfoot,
If it's not too late for you, post your question in the RSD (reflex sympathetic dystrophy) forum. Those folks have lots of experience with the ketamine infusion. I think this is a relatively new approach for PN. Please let us know how it goes.
Lucindamw

[Yorkiemom]

Now this is a new one on me... What is this? It seems to me like the vet used to use that to put some of my parrots to sleep (permanently).

In small doses, perhaps it doesn't have the longlasting and final effect.

Cathie

[LizaJane]

I found 2 articles on the use of ketamine infusions for peripheral nerve pain, one for pn, and one for complex regional pain syndrome. Both showed impressive improvements in pain, but a significan side effect of hallucinations.

I had ketamine anesthesia for oral surgery when I was 13, and to this day I recall the trauma of the psychosis I had from it. When I woke up from having the dental work, I was convinced that my body was still being operated on, and that this body I was in was a double, and that my parents and everyone else were doubles. For THREE DAYS I was terrified, thinking I was in the home of people who were pretending to be my parents, with a grandmother who was also a pretender making me chicken soup.

So it wasn't just a few hallucinations I had, it was frank delusions for 3 days. I had flashbacks to the experience for, oh, maybe 20 years or so.

This treatment I would not jump for.


1: Pain Med. 2004 Sep;5(3):263-75. Related Articles, Links


Subanesthetic ketamine infusion therapy: a retrospective analysis of a novel therapeutic approach to complex regional pain syndrome.

Correll GE, Maleki J, Gracely EJ, Muir JJ, Harbut RE.

Anaesthetics Department, Mackay Base Hospital, Mackay, Queensland, Australia.

Complex Regional Pain Syndrome (CRPS) is a disorder that can be accompanied by severe pain that is often both chronic and resistant to conventional therapy. Harbut and Correll previously reported the successful treatment of a 9-year case of intractable Type I CRPS with an intravenous inpatient infusion of ketamine in an adult female patient. OBJECTIVE: The purpose of this study was to ascertain if indeed the use of subanesthetic inpatient infusions of ketamine provide meaningful improvements in pain scores, and thus, quality of life, in patients suffering from CRPS. To achieve this objective we focused our analysis on the relief of pain obtained by patients undergoing this novel treatment option developed at Mackay Base Hospital, Queensland, Australia. METHODS: Case notes of 33 patients whose CRPS pain was treated by the inpatient administration of a continuous subanesthetic intravenous infusion of ketamine were reviewed. The dose and duration of ketamine therapy and the degree and duration of relief obtained were recorded. Notable side effects were also recorded. The degree of relief obtained (immediately after the infusion) was assessed using pre- and posttreatment numeric pain scores. The duration of relief obtained (throughout the follow-up period) was analyzed using a Kaplan-Meier cumulative survival curve analysis. RESULTS: A total of 33 patients with diagnoses of CRPS who had undergone ketamine treatment at least once were identified. Due to relapse, 12 of 33 patients received a second course of therapy, and two of 33 patients received a third. The degree of relief obtained following the initial course of therapy was impressive (N=33); there was complete pain relief in 25 (76%), partial relief in six (18%), and no relief in two (6%) patients. The degree of relief obtained following repeat therapy (N=12) appeared even better, as all 12 patients who received second courses of treatment experienced complete relief of their CRPS pain. The duration of relief was also impressive, as was the difference between the duration of relief obtained after the first and after the second courses of therapy. In this respect, following the first course of therapy, 54% of 33 individuals remained pain free for >/=3 months and 31% remained pain free for >/=6 months. After the second infusion, 58% of 12 patients experienced relief for >/=1 year, while almost 33% remained pain free for >3 years. The most frequent side effect observed in patients receiving this treatment was a feeling of inebriation. Hallucinations occurred in six patients. Less frequent side effects also included complaints of lightheadedness, dizziness, and nausea. In four patients, an alteration in hepatic enzyme profile was noted; the infusion was terminated and the abnormality resolved thereafter. CONCLUSION: This retrospective review suggests that limited subanesthetic inpatient infusions of ketamine may offer a promising therapeutic option in the treatment of appropriately selected patients with intractable CRPS. More study is needed to further establish the safety and efficacy of this novel approach.

PMID: 15367304 [PubMed - indexed for MEDLINE]

--------------------------------------------------------------------------------

2: Acta Anaesthesiol Scand. 2003 Aug;47(7):868-77. Related Articles, Links


The effectiveness of intravenous ketamine and lidocaine on peripheral neuropathic pain.

Kvarnstrom A, Karlsten R, Quiding H, Emanuelsson BM, Gordh T.

Department of Anesthesiology and Intensive Care, Uppsala University Hospital, Uppsala, Sweden. ann.kvarnstrom@thorax.uas.lul.se

BACKGROUND: Neuropathic pain is often severe and resistant to pharmacological treatment. The aims of the present study were to assess the analgesic effect of ketamine and lidocaine and to investigate if measurement of different variables of sensibility could be used to identify responders. We also wanted to study if treatment resulted in changes of sensibility. METHODS: Twelve patients with long-lasting peripheral neuropathic pain of traumatic origin were included. The effects of ketamine hydrochloride (Ketalar, Parke Davis) 0.4 mg/kg and lidocaine hydrochloride (Xylocain, Astra) 2.5 mg/kg were investigated. Saline was used as placebo. The intensity of continuous pain was measured by a visual analogue scale (VAS). Warm and cold perception as well as heat and cold pain thresholds were assessed. Sensibility to touch was also tested. Systemic plasma concentrations of lidocaine and ketamine were assessed. RESULTS: The mean reduction in VAS-scores was 55%, 34% and 22% for ketamine, lidocaine and placebo, respectively. A significant difference was registered between ketamine and placebo (P = 0.009). Response to treatment (50% reduction in VAS-score during infusion) was recorded in 7/12 in the ketamine, 4/12 in the lidocaine and 2/12 in the placebo group. Quantitative sensory testing (QST) of thermal sensitivity and sensory tests for mechanical stimuli could not separate responders from non-responders and neither were the results from these assessments changed by the infusion of the drugs. Lidocaine and particularly ketamine were associated with frequent side-effects, the most common being somnolence and dizziness. CONCLUSION: Ketamine showed a significant analgesic effect. The clinical usefulness is, however, limited by disturbing side-effects.

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 12859309 [PubMed - indexed for MEDLINE]

[LizaJane]

did you get the ketamine?

[drg]

there is a clinic in Houston i saw that does alpha lipoic acid infusion

http://www.longevityhouston.com/hormonetherapy.html

I dont anything about how effective it is though..

[nide44]

there is a clinic in Houston i saw that does alpha lipoic acid infusion

http://www.longevityhouston.com/hormonetherapy.html

I dont anything about how effective it is though..

I saw nothing about ALA or injections on this page.
Only 'hormone therapy' for anti-aging.
Upon a brief inspection of 2 other pages, same resuilt-nothing about ALA.

[Norway]

Thank you LizaJane for sharing your experience! I have read of the hallucinations, but not how severe it can be. I understand you never forgot such a horrible event!

I have both CRPS/rsd and Neuropathy, and have often wondered if this could do both.

However, I have tried Lidocain-infusion once a week for several months. At first it helped, most in my CRPS-arms, but never touch th neuropathy in my feets.
It stopped working in my arms too after a while. And this can effect your heart so it most be monitered while getting the infusion.

Som CRPS/RSD'rs had help with Ketamine, but after a while it seems to come back.

Has anyone else had a lidocain-infusion?

[amb97]

My dearest friend has been at Methodist Hospital for five months following an experimental treatment for liver cancer (stage 4 breat cancer). I went there to support her. The added activity caused my PN to really flair up and I was hobbling outside the hospital when I came up on a patient sitting outside having a cigarette who asked why I was limping. As it turned out, she was there for polyneuropathy and highly recommended Dr. Everton Edmonson, Neurologist, Neuro Oncologist, and Pain Management Specialist. She flies there from Colorado to see him. Before I knew it, three other patients there told me about him, I saw it as a sign.

I had previously seen three neuro's who offered no treatment options and no hope. I have a super pain mgmt team but still have to beg for adequate pain meds. How could I not at least hear what he had to offer?

Ketamine Infusion has been a standard treatment in Canada for years, but because it causes similar effects of LSD (hallucinations, paranoia, "trip effect"), the medical community has been reluctant to adopt it here.

What I was told is that the treatment will be done in a recovery room type setting. The IV infusion takes approx 30 minutes, then I'll stay for observation for 45 min. to an hour while I "trip". The long term benefit (one week to one month) is pain suppression and a detox effect, where it breaks down the tolerence to opiate meds and they can lower the doses that have been raised over the years.

I contacted my pain group in new york and they are very interested in the outcome. They may be willing to administer if I get a good result, and depending on how it goes over the next year, may offer it to other PN patients.

It must really be cutting edge since no one has responded with their own stories.
As a side note, why the interest on the location and not the treatment?

Did you see Dr. Edmonson?? If so, how did it go?? I live in Housotn, and am looking for a doctor who does the low-dose Ketamine treatment. I'm wondering if I could even get in to see him. Any insight??