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HeadWay, Issue #135 -- Infusion Therapy: Ketamine and Lidocaine
October 22, 2015

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In this issue:

Infusion Therapy: Ketamine and Lidocaine

Say what?! Infusion Therapy

Infusion Therapy: Ketamine and Lidocaine

This edition is in answer to a question from Kimm in the USA. Kimm was asking for information about IV or infusion therapy, particularly involving ketamine and lidocaine.

There are actually a number of different infusions that are used for headache conditions, particularly for a migraine attack that just won't stop (intractable or refractory migraine), or a cluster headache attach which, by its nature, just keeps coming back.

One of the best and well known treatments for intractable migraine is a magnesium infusion. Lidocaine or ketamine treatments are a little more unusual, though not completely new, and some people have found them helpful.

When it comes to these types of infusion treatments, patients are aiming for one or two goals. First, to break the ongoing vicious cycle of symptoms, to get things at least down to a level where things start getting better, or can be treated in more conventional ways.

Second, some patients have found ongoing relief from symptoms - several days without cluster attacks, or even several weeks or months with fewer or no migraine attacks.

Lidocaine is typically used as an anesthetic for surgery and labor. It has gained interest as a chronic pain treatment in certain cases. Chronic daily headache is one of the headache conditions that may be treated with a lidocaine infusion, along with migraine and cluster. It's also used for fibromyalgia.

A preliminary study this past spring showed promise in a specific lidocaine treatment for migraine and cluster.

Ketamine also shows promise, but it is probably the more controversial of the two. For both treatments, more quality studies are needed.

Ketamine has also been used with success for both migraine and cluster headache. It's also used for conditions such as fibromyalgia and depression. There is hope that ketamine may also help counter the effects of opioid medications, which can make migraine symptoms significantly worse over time.

We won't take the time here to discuss all the pros and cons of ketamine and lidocaine infusion treatments. There are probably infusion treatments that your doctor will want to try before these, in particular before lidocaine. However, for patients who have pain that just won't stop with conventional treatments, these may be something to discuss with your doctor.

Here are a few resources to get you started in your research:

Watch for it – Ketamine for Migraine and More (a quick overview of ketamine from a few years ago)
IV Treatment of Refractory Migraines (a study of some common IV treatments)
I.V. Success for Refractory Headaches (older but helpful information about lidocaine and ketamine infusion treatments)
Ketamine Infusion (an overview for patients preparing for the treatment)
Ketamine for chronic pain: risks and benefits (in-depth overview)
Image-guided treatment shown to break the migraine cycle (a lidocaine study)
My experience with Ketamine (a personal story from a woman with chronic migraine)
Promising drug treatments available to people suffering from cluster headaches (from the founder of the Cluster Headache Support Group)
The Best Medication for Migraine? The AHS Reports (not everyone agrees about the benefits of lidocaine)

Say what?! Infusion Therapy

In the article above, we were actually discussion a lot more than just IV, or intravenous, therapy. IV refers specifically to administration of a fluid directly into a vein.

Infusion therapy often refers to the same thing, but can refer to administration by other means. For example, in the lidocaine study from the spring (mentioned above), a catheter was guided through nasal passages to administer the lidocaine to the sphenopalatine ganglion, a nerve bundle behind the nose.

Thanks for reading! Remember, if you have feedback or ideas for future issues, visit the HeadWay MailRoom. Your password is nomoache.

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