Patients using ketamine have shared with our pharmacy that they were formerly suffering from depression and chronic pain and now have found themselves doing jumping jacks in the living room, hauling heavy garden hoses, and with a renewed interest in reading, which they hadn’t had for years.
Katmine Background and Current Compounding Practices
Ketamine is a drug used most commonly as an intravenous anesthetic for human and veterinary surgery. It was developed in 1962 and was first used for American soldiers injured in Vietnam. At high doses, it puts people into a dreamlike, semi-conscious state where they can undergo surgery without feeling any pain. The dose usually prescribed for chronic pain is about 2% of the dose used for anesthesia.
Oral, Nasal, or Sublingual Use of Ketamine
While intravenous ketamine can only be given to patients in the hospital under the direction of an anesthesiologist, the drug can be used safely by patients either in or out of the hospital when swallowed, nasally, or placed under the tongue. It has to be specially prepared by a compounding pharmacy, as it is currently not made by drug companies in a form for oral or sublingual use.
The Research and Application of Ketamine for Pain and Depression
Protocol for New Prescribers
Topical Ketamine-Reduction of allodynia in cases of complex regional pain syndrome
A double-blind placebo-controlled crossover trial showed that in patients with Complex Regional Pain Syndrome (CRPS; also known as Reflex Sympathetic Dystrophy), topical application of ketamine 10% cream caused a reduction in allodynia, a most unpleasant aspect of this condition. This study shows promise for the use of topical ketamine as opposed to parenteral and oral forms which often result in undesirable side effects.
Pain. 2009 Nov;146(1-2):18-25.
Reduction of allodynia in patients with complex regional pain syndrome: A double-blind placebo-controlled trial of topical ketamine.
Click here to access the PubMed abstract of this article.
Sublingual Ketamine for Chronic Pain and/or Depression Information for Prescribers
Spravato vs. Compounded Ketamine
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