Migraine pain could be eased with ketamine, study finds

Migraine is one of the most common and debilitating conditions in the United States. While there are therapies that can help to manage migraine, not all patients respond. A new study finds that ketamine, which is a drug primarily used as an anesthetic, could offer an alternative treatment.

Migraine is a condition characterized by recurrent attacks of moderate or severe headaches, most commonly on one side of the head.

Some people with migraine may also experience visual disturbances, such as blind spots, tunnel vision, or temporary blindness. This is known as migraine with aura.

According to the Migraine Research Foundation, around 39 million men and women in the U.S. experience migraine. Of these, around 4 million have at least 15 migraine days every month.

There are several medications and non-drug therapies that can help to prevent migraine attacks, or at least lessen their severity. However, some migraine patients fail to respond to existing treatments, highlighting the need for more therapeutic options.

Dr. Eric Schwenk, the director of orthopedic anesthesia at Thomas Jefferson University Hospital in Philadelphia, PA, and colleagues believe that ketamine could meet this need.

In a new study, Dr. Schwenk and team found that nearly three quarters of migraine patients treated with the drug experienced a reduction in migraine pain intensity.

The researchers recently presented their findings at the Anesthesiology 2017 annual meeting, held in Boston, MA.

Migraine pain intensity reduced

For their study, the researchers reviewed the data of 61 patients, all of whom had intractable migraine — that is, migraine that is hard to treat, has stopped responding to currently available treatments, or both.

All patients were treated with ketamine infusions for 3–7 days. Ketamine is a medication most commonly used for anesthesia, but it may also be used for pain relief, and it is currently being investigated as a treatment for depression.

After the treatment, almost 75 percent of the study participants reported a reduction in the intensity of their migraine pain, the team reports.

At study baseline, the average migraine pain rating among participants was 7.5 on a scale of 1–10. By the end of the study, this had reduced to 3.4.

The researchers found that the lowest migraine pain ratings occurred on the fourth day of ketamine infusion, and that adverse effects reported among study participants were mild.

A promising treatment for migraine?

Dr. Schwenk and his colleagues note that because their study is retrospective, they are unable to make any firm conclusions about the effect of ketamine on migraine pain.

However, they believe that their research shows promise for the drug and helps to set the stage for future studies.

"Ketamine may hold promise as a treatment for migraine headaches in patients who have failed other treatments. Our study focused only on short-term relief, but it is encouraging that this treatment might have the potential to help patients long-term."

Dr. Eric Schwenk

"Our work provides the basis for future, prospective studies that involve larger numbers of patients," adds Dr. Schwenk.