Ketamine nasal spray may be a promising treatment for chronic migraine, reducing headache intensity and improving quality of life, researchers say today.
Ketamine is sometimes used by intravenous infusion as a remedy for migraine, due to its effect on brain receptors and its potential antidepressant effect, the researchers say.
Dr Michael Marmura of Thomas Jefferson University, Philadelphia, USA, and his team looked at the effectiveness of a nasal ketamine spray for outpatient use.
They carried out interviews with 169 patients treated this way and found that intranasal ketamine was deemed “very effective” by 49% of patients, and quality of life was considered “much better” by 36%.
Details appear in Regional Anesthesia & Pain Medicine today. The authors write: “In this descriptive study, intranasal ketamine served as an acute treatment for refractory chronic migraine by reducing headache intensity and improving quality of life with relatively tolerable adverse events.”
The authors add that most patients continued with intranasal ketamine despite minor adverse events.
But they add, “Given the potential for overuse, it should be reserved for those clearly in need of more effective rescue treatment with appropriate safety precautions.”
The team call for placebo-controlled trials to establish the safety and effectiveness of this approach.
They state: “This should be addressed carefully and individually, as some may respond only to repeated intranasal ketamine while some may overuse it. Clinicians should only consider the use of a potentially addictive medication such as ketamine for significantly disabled patients with migraine.”
Yuan, H. et al. Real-world study of intranasal ketamine for use in patients with refractory chronic migraine: a retrospective analysis. Regional Anesthesia & Pain Medicine 31 May 2023; doi: 10.1136/rapm-2022-104223
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