Recently, there has been increasing publicity concerning Intravenous Ketamine Infusion as a treatment for chronic pain, particularly in people suffering Complex Regional Pain Syndrome (CRPS).

Ketamine is an anaesthetic, often more associated with veterinary practice. More illicitly it is used recreationally for its hallucinogenic effects and, more disturbingly, is also known colloquially as a “date rape” drug.

So how might Ketamine benefit those suffering CRPS?

The first thing to say is that Intravenous Ketamine Infusion as a treatment for CRPS remains controversial. To date only small scale and therefore relatively weak clinical trials have been performed and that clearly affects its current availability as a treatment option.

That said, Ketamine seems to have a strong ability to block NMDA receptors in nerve cells. These receptors are very important for controlling ‘memory’ in nerve cells.

To put that into context, chronic pain is often the result of trauma to nerve endings, which continue sending pain signals to the brain even when the original injury to the surrounding tissue has, to all intents and purposes, healed. It is thought that Ketamine helps to block these ‘wrong’ pain signals which are ‘memories’ of the now healed original injury.

However, it seems that Ketamine may additionally help to stimulate the growth of new nerve pathways. As the new nerve endings have no ‘memory’ of the original trauma, they send only normal, healthy signals to the brain. This process has been likened to rebooting a computer.

Interestingly, researchers have found that Intravenous Ketamine Infusion can also be successful in treating therapy-resistant depression.

What does the treatment involve?

As the name suggests, the treatment involves introducing the drug intravenously in a very dilute form over what may be a number of hours. These treatments are usually intensive, involving a number of sessions over a few days. Sometimes a short stay in hospital is required.

Can Intravenous Ketamine Infusion cure CRPS?

Sadly, Intravenous Ketamine Infusion cannot cure CRPS. If successful, the treatment may produce relief from symptoms for a period of time, possibly up to a few months, but generally patients have to return for booster sessions to prolong the pain relieving effects of the treatment. However, for somebody suffering CRPS, even some short to medium term relief from their pain is to be welcomed.

Does the treatment produce any side effects?

Many patients do report that the treatment does have a number of short term side effects. Headaches, nausea, night terrors and hallucinations have all been reported. These symptoms tend to be relatively short lived. However, more worryingly, excessive use of Ketamine can lead to serious, permanent damage to the bladder, known as Ketamine Bladder Syndrome or Ketamine Cystitis. This was first reported as recently as 2007 in the context of its illicit use as a recreational drug. Ketamine Bladder Syndrome occurs where damage to the lining of the bladder due to over use of Ketamine causes the bladder to shrink, resulting in serious and painful urological problems.