Low Doses Of A Common Intravenous Anesthetic May Relieve Debilitating Pain Syndrome
“Limited, low-dose infusions of a widely used anesthetic drug may relieve the often intolerable and debilitating pain of Complex Regional Pain Syndrome (CRPS), a Penn State Milton S. Hershey Medical Center researcher found. “
This is an article on the Low-Dose Ketamine Infusion treatment for RSD patients covering NINE YEARS of it’s use in treating and helping CRPS patients, dating back to around 1995! Doctor’s Harbut and Correll were getting 75% success rate way back then with these patients.
This article was written by the two author’s who did the previous article (see below); Dr. Correll and Dr Harbut as well as other authors as stated in the article.
We have been very fortunate to have had the company that handles re-print requests for this Pain Journal, allow visitors to the American RSDHope website access to read this article.
You may link from your site to the to this RSDHope page describing it.
Also, copying and printing of the article is not allowed as this is copyrighted information. Re-print information is available on the website and also at the end of this page.
These folks have been great, thank you BLACKWELL PUBLISHING!
Here is just a taste.
“Complex Regional Pain Syndrome (CRPS) is a disorder that can be accompanied by severe pain that is often both chronic and resistant to conventional therapy. Harbut and Correll previously reported the successful treatment of a 9-year case of intractable Type I CRPS with an intravenous inpatient infusion of ketamine in an adult female patient “
” Objective. The purpose of this study was to ascertain if indeed the use of subanesthetic inpatient infusions of ketamine provide meaningful improvements in pain scores, and thus, quality of life, in patients suffering from CRPS. To achieve this objective we focused our analysis on the relief of pain obtained by patients undergoing this novel treatment option developed at Mackay Base Hospital, Queensland, Australia. “
“Results. A total of 33 patients with diagnoses of CRPS who had undergone ketamine treatment at least once were identified. Due to relapse, 12 of 33 patients received a second course of therapy, and two of 33 patients received a third. The degree of relief obtained following the initial course of therapy was impressive (N=33); there was complete pain relief in 25 (76%), partial relief in six (18%), and no relief in two (6%) patients. The degree of relief obtained following repeat therapy (N=12) appeared even better, as all 12 patients who received second courses of treatment experienced complete relief of their CRPS pain.
The duration of relief was also impressive, as was the difference between the duration of relief obtained after the first and after the second courses of therapy. In this respect, following the first course of therapy, 54% of 33 individuals remained pain free for 3 months and 31% remained pain free for 6 months. After the second infusion, 58% of 12 patients experienced relief for 1 year, while almost 33% remained pain free for >3 years. The most frequent side effect observed in patients receiving this treatment was a feeling of inebriation. Hallucinations occurred in six patients. Less frequent side effects also included complaints of lightheadedness, dizziness, and nausea. In four patients, an alteration in hepatic enzyme profile was noted; the infusion was terminated and the abnormality resolved thereafter.”
…..
“Conclusion. This retrospective review suggests that limited subanesthetic inpatient infusions of ketamine may offer a promising therapeutic option in the treatment of appropriately selected patients with intractable CRPS. More study is needed to further establish the safety and efficacy of this novel approach.”
The full article published in Pain Medicine, the official journal of the American Academy of Pain Medicine, is very extensive and includes all the numbers and charts you could want. This will be an invaluable tool to share with your Drs..
Since this study was completed, much, much more has been learned and the success rates and relief obtained have improved significantly.
For more information on getting re-prints or jounal copies, contact;
Dave Surdel
Medical Sales Representative
Blackwell Publishing
350 Main Street
Malden, MA 02148
Tel: 781-388-8200
the article can be found by GOING HERE TO THE SCIENCE DAILY WEBSITE
If you would like to contact Dr. Harbut at his new clinic, The Hot Springs Pain Institute, to be seen as a pain patient or for low-dose ketamine treatment, you can contact the clinic at (501) 651-4488 or Fax (501) 651-4490.
“Limited, low-dose infusions of a widely used anesthetic drug may relieve the often intolerable and debilitating pain of Complex Regional Pain Syndrome (CRPS), a Penn State Milton S. Hershey Medical Center researcher found. “
This is an article on the Low-Dose Ketamine Infusion treatment for RSD patients covering NINE YEARS of it’s use in treating and helping CRPS patients, dating back to around 1995! Doctor’s Harbut and Correll were getting 75% success rate way back then with these patients.
This article was written by the two author’s who did the previous article (see below); Dr. Correll and Dr Harbut as well as other authors as stated in the article.
We have been very fortunate to have had the company that handles re-print requests for this Pain Journal, allow visitors to the American RSDHope website access to read this article.
You may link from your site to the to this RSDHope page describing it.
Also, copying and printing of the article is not allowed as this is copyrighted information. Re-print information is available on the website and also at the end of this page.
These folks have been great, thank you BLACKWELL PUBLISHING!
Here is just a taste.
“Complex Regional Pain Syndrome (CRPS) is a disorder that can be accompanied by severe pain that is often both chronic and resistant to conventional therapy. Harbut and Correll previously reported the successful treatment of a 9-year case of intractable Type I CRPS with an intravenous inpatient infusion of ketamine in an adult female patient “
” Objective. The purpose of this study was to ascertain if indeed the use of subanesthetic inpatient infusions of ketamine provide meaningful improvements in pain scores, and thus, quality of life, in patients suffering from CRPS. To achieve this objective we focused our analysis on the relief of pain obtained by patients undergoing this novel treatment option developed at Mackay Base Hospital, Queensland, Australia. “
“Results. A total of 33 patients with diagnoses of CRPS who had undergone ketamine treatment at least once were identified. Due to relapse, 12 of 33 patients received a second course of therapy, and two of 33 patients received a third. The degree of relief obtained following the initial course of therapy was impressive (N=33); there was complete pain relief in 25 (76%), partial relief in six (18%), and no relief in two (6%) patients. The degree of relief obtained following repeat therapy (N=12) appeared even better, as all 12 patients who received second courses of treatment experienced complete relief of their CRPS pain.
The duration of relief was also impressive, as was the difference between the duration of relief obtained after the first and after the second courses of therapy. In this respect, following the first course of therapy, 54% of 33 individuals remained pain free for 3 months and 31% remained pain free for 6 months. After the second infusion, 58% of 12 patients experienced relief for 1 year, while almost 33% remained pain free for >3 years. The most frequent side effect observed in patients receiving this treatment was a feeling of inebriation. Hallucinations occurred in six patients. Less frequent side effects also included complaints of lightheadedness, dizziness, and nausea. In four patients, an alteration in hepatic enzyme profile was noted; the infusion was terminated and the abnormality resolved thereafter.”
…..
“Conclusion. This retrospective review suggests that limited subanesthetic inpatient infusions of ketamine may offer a promising therapeutic option in the treatment of appropriately selected patients with intractable CRPS. More study is needed to further establish the safety and efficacy of this novel approach.”
The full article published in Pain Medicine, the official journal of the American Academy of Pain Medicine, is very extensive and includes all the numbers and charts you could want. This will be an invaluable tool to share with your Drs..
Since this study was completed, much, much more has been learned and the success rates and relief obtained have improved significantly.
For more information on getting re-prints or jounal copies, contact;
Dave Surdel
Medical Sales Representative
Blackwell Publishing
350 Main Street
Malden, MA 02148
Tel: 781-388-8200
the article can be found by GOING HERE TO THE SCIENCE DAILY WEBSITE
If you would like to contact Dr. Harbut at his new clinic, The Hot Springs Pain Institute, to be seen as a pain patient or for low-dose ketamine treatment, you can contact the clinic at (501) 651-4488 or Fax (501) 651-4490.
Subanesthetic Ketamine Infusion Therapy: A Retrospective Analysis of a Novel Therapeutic Approach to Complex Regional Pain Syndrome
PAIN MEDICINE Volume 5 – Number 3 – 2004
Graeme E. Correll, BE, MBBS, FANZCA,* Jahangir Maleki, MD, PhD,† Edward J. Gracely, PhD,‡ Jesse J. Muir, MD,§ and Ronald E. Harbut, MD, PhD¶
*Anaesthetics Department, Mackay Base Hospital, Mackay, Queensland, Australia; †Drexel University College of Medicine, Medical College of Pennsylvania Hospital, Philadelphia, Pennsylvania; ‡Department of Family, Community, and Preventive Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania; §Department of Anesthesiology, Mayo Clinic Scottsdale, Scottsdale, Arizona; ¶Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
*Anaesthetics Department, Mackay Base Hospital, Mackay, Queensland, Australia; †Drexel University College of Medicine, Medical College of Pennsylvania Hospital, Philadelphia, Pennsylvania; ‡Department of Family, Community, and Preventive Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania; §Department of Anesthesiology, Mayo Clinic Scottsdale, Scottsdale, Arizona; ¶Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
ABSTRACT
Complex Regional Pain Syndrome (CRPS) is a disorder that can be accompanied by severe pain that is often both chronic and resistant to conventional therapy. Harbut and Correll previously reported the successful treatment of a 9-year case of intractable Type I CRPS with an intravenous inpatient infusion of ketamine in an adult female patient [1].
Objective. The purpose of this study was to ascertain if indeed the use of subanesthetic inpatient infusions of ketamine provide meaningful improvements in pain scores, and thus, quality of life, in patients suffering from CRPS. To achieve this objective we focused our analysis on the relief of pain obtained by patients undergoing this novel treatment option developed at Mackay Base Hospital, Queensland, Australia.
Methods. Case notes of 33 patients whose CRPS pain was treated by the inpatient administration of a continuous subanesthetic intravenous infusion of ketamine were reviewed. The dose and dura- tion of ketamine therapy and the degree and duration of relief obtained were recorded. Notable side effects were also recorded. The degree of relief obtained (immediately after the infusion) was assessed using pre- and posttreatment numeric pain scores. The duration of relief obtained (throughout the follow-up period) was analyzed using a Kaplan-Meier cumulative survival curve analysis.
Results. A total of 33 patients with diagnoses of CRPS who had undergone ketamine treatment at least once were identified. Due to relapse, 12 of 33 patients received a second course of therapy, and two of 33 patients received a third. The degree of relief obtained following the initial course of therapy was impressive (N = 33); there was complete pain relief in 25 (76%), partial relief in six (18%), and no relief in two (6%) patients. The degree of relief obtained following repeat therapy (N = 12) appeared even better, as all 12 patients who received second courses of treatment experi- enced complete relief of their CRPS pain. The duration of relief was also impressive, as was the difference between the duration of relief obtained after the first and after the second courses of therapy. In this respect, following the first course of therapy, 54% of 33 individuals remained pain free for ≥3 months and 31% remained pain free for ≥6 months. After the second infusion, 58% of 12 patients experienced relief for ≥1 year, while almost 33% remained pain free for >3 years. The most frequent side effect observed in patients receiving this treatment was a feeling of inebriation. Hallucinations occurred in six patients. Less frequent side effects also included complaints of light- headedness, dizziness, and nausea. In four patients, an alteration in hepatic enzyme profile was noted; the infusion was terminated and the abnormality resolved thereafter.
Reprint requests to: Ronald E. Harbut, M.D., Ph.D., Department of Anesthesiology, H187, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, Pennsylvania 17033. Tel: (717) 531-5680; Fax: (717) 531-4204; Jahangir Maleki, MD, PhD, Drexel University College of Medicine, Medical College of Pennsylvania Hospital, 3300 Henry Avenue, Philadelphia, PA 19129. Tel: (215) 842-7335; Fax: (215) 843-4467.
© American Academy of Pain Medicine 1526-2375/04/$15.00/263 263–275
264
Correll et al.
Conclusion. This retrospective review suggests that limited subanesthetic inpatient infusions of ket- amine may offer a promising therapeutic option in the treatment of appropriately selected patients with intractable CRPS. More study is needed to further establish the safety and efficacy of this novel approach.
Key Words. Alpha-2-Adrenergic Agonist; Central Sensitization; Complex Regional Pain Syndrome; Ketamine; Neuropathic Pain; Noncompetitive NMDA Receptor Antagonist
For the link to the complete article, visit PAIN MEDICINE – VOLUME 5 – 2004 – HARBUT – KETAMINE
Complex Regional Pain Syndrome (CRPS) is a disorder that can be accompanied by severe pain that is often both chronic and resistant to conventional therapy. Harbut and Correll previously reported the successful treatment of a 9-year case of intractable Type I CRPS with an intravenous inpatient infusion of ketamine in an adult female patient [1].
Objective. The purpose of this study was to ascertain if indeed the use of subanesthetic inpatient infusions of ketamine provide meaningful improvements in pain scores, and thus, quality of life, in patients suffering from CRPS. To achieve this objective we focused our analysis on the relief of pain obtained by patients undergoing this novel treatment option developed at Mackay Base Hospital, Queensland, Australia.
Methods. Case notes of 33 patients whose CRPS pain was treated by the inpatient administration of a continuous subanesthetic intravenous infusion of ketamine were reviewed. The dose and dura- tion of ketamine therapy and the degree and duration of relief obtained were recorded. Notable side effects were also recorded. The degree of relief obtained (immediately after the infusion) was assessed using pre- and posttreatment numeric pain scores. The duration of relief obtained (throughout the follow-up period) was analyzed using a Kaplan-Meier cumulative survival curve analysis.
Results. A total of 33 patients with diagnoses of CRPS who had undergone ketamine treatment at least once were identified. Due to relapse, 12 of 33 patients received a second course of therapy, and two of 33 patients received a third. The degree of relief obtained following the initial course of therapy was impressive (N = 33); there was complete pain relief in 25 (76%), partial relief in six (18%), and no relief in two (6%) patients. The degree of relief obtained following repeat therapy (N = 12) appeared even better, as all 12 patients who received second courses of treatment experi- enced complete relief of their CRPS pain. The duration of relief was also impressive, as was the difference between the duration of relief obtained after the first and after the second courses of therapy. In this respect, following the first course of therapy, 54% of 33 individuals remained pain free for ≥3 months and 31% remained pain free for ≥6 months. After the second infusion, 58% of 12 patients experienced relief for ≥1 year, while almost 33% remained pain free for >3 years. The most frequent side effect observed in patients receiving this treatment was a feeling of inebriation. Hallucinations occurred in six patients. Less frequent side effects also included complaints of light- headedness, dizziness, and nausea. In four patients, an alteration in hepatic enzyme profile was noted; the infusion was terminated and the abnormality resolved thereafter.
Reprint requests to: Ronald E. Harbut, M.D., Ph.D., Department of Anesthesiology, H187, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, Pennsylvania 17033. Tel: (717) 531-5680; Fax: (717) 531-4204; Jahangir Maleki, MD, PhD, Drexel University College of Medicine, Medical College of Pennsylvania Hospital, 3300 Henry Avenue, Philadelphia, PA 19129. Tel: (215) 842-7335; Fax: (215) 843-4467.
© American Academy of Pain Medicine 1526-2375/04/$15.00/263 263–275
264
Correll et al.
Conclusion. This retrospective review suggests that limited subanesthetic inpatient infusions of ket- amine may offer a promising therapeutic option in the treatment of appropriately selected patients with intractable CRPS. More study is needed to further establish the safety and efficacy of this novel approach.
Key Words. Alpha-2-Adrenergic Agonist; Central Sensitization; Complex Regional Pain Syndrome; Ketamine; Neuropathic Pain; Noncompetitive NMDA Receptor Antagonist
For the link to the complete article, visit PAIN MEDICINE – VOLUME 5 – 2004 – HARBUT – KETAMINE
KETAMINE INFUSIONS USED TO TREAT DEPRESSION?
Is Club Drug ‘Special K’ a Quick Fix for Depression?
Natalie Wolchover, Life’s Little Mysteries Staff Writer
LiveScience.com – Tue Jan 31, 3:10 pm About 30 million Americans suffer from depression, and when a sudden wave of severe symptoms hits them, there’s no instant fix. The most commonly prescribed drugs — Prozac, Celexa and Zoloft — take a few weeks to kick in, and in the meantime, depressed people are at an escalated risk of suicide. More than half the time, the prescribed drug doesn’t end up working at all, and patients must start over with a different treatment.
But there’s a new drug in town: ketamine. It’s not new, exactly — it has been used as an anesthetic for decades, and it’s a popular drug among night clubbers (called, in that context, “Special K”). But after noticing the euphoric effect the drug seems to have on anesthetized patients, psychiatrists have begun conducting clinical trials of ketamine as an anti-depression medication. The initial results are extremely promising.
“Once the patient takes ketamine, it causes euphoria and a rapid antidepressant effect within two hours,” said Asim Shah, associate chief of psychiatry at Ben Taub General Hospital in Houston and a professor at Baylor College of Medicine, where the new study is taking place. Furthermore, ketamine helps a greater proportion of the affected population than traditional antidepressants. Prozac and other treatments each improve conditions for only about 30 to 40 percent of the patient population, barely outperforming placebos; meanwhile, a single infusion of ketamine washes away the symptoms of 80 to 90 percent of patients who try it, Shah said.
Scientists understand how ketamine chemically affects the brain, but they don’t quite know why it alleviates depressive symptoms. According to Ken Robbins, a clinical professor of psychiatry at the University of Wisconsin-Madison, ketamine binds to portals in the brain called NMDA receptors; this prevents a chemical called glutamate from occupying the same spots. Because glutamate revs up the system and can cause cell damage, ketamine has a sedative effect by blocking it. Somehow, this causes euphoria.
“The hypotheses for why ketamine might be helping depression are in their infancy,” Robbins said. Whatever the explanation, “it’s a very different mechanism from that of other anti-depressants we now use. I think what we’re seeing is there may be a whole other neurotransmitter system that plays a role in depression that we weren’t aware of.”
In the new study — a joint effort of Baylor College of Medicine’s Neuropsychiatric Center and researchers at Mount Sinai Hospital — depressed patients are given one dose of ketamine, and doctors monitor how long this keeps their depression at bay.
“We’re seeing the benefits lasting a few days to a few weeks,” Shah said. The researchers are already planning a follow-up study in which six infusions of ketamine will be administered. If the positive results continue, Shah believes the Food and Drug Administration will eventually approve the drug for use as an antidepressant; he hopes it will become available in two years, though the drug will be more expensive than the $4 per month cost of generic versions of Prozac.
The researchers suspect that ketamine — which is addictive, and must be administered intravenously — will most likely end up being used in tandem with other drugs, rather than replacing them. It would make a good temporary fix, significantly reducing patients’ suicide risk, while they wait for longer-term treatments to kick in.
Some doctors are administering ketamine as a quick fix for depression already. “The fact of the matter is people have picked up on the promising research results, and doctors are prescribing it off-label without FDA approval. Even if it is not approved, when you tell a patient, ‘I have an anesthetic agent that is an instant fix for your depression,’ they want it,” Shah said.
This puts doctors at risk of getting sued if the unapproved treatment turns out to be ineffective, and the scientists say it would be best for doctors and patients to wait until the research process has run its course.
“I don’t want people to think that taking ketamine illegally or from the streets will treat depression,” Shah said. “Taking the wrong dose or taking too much of it might make you even more psychotic.”
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Dr. Ronald Harbut Develops An App For I-Phone and I-Pad To Track Chronic Pain
Doctor Ronald Harbut, an Anesthesiologist and Pain Management Specialist who has spent many years working with Complex Regional Pain Syndrome patients and helped to develop the process of treating the disease with infusions of ketamine ( as noted in the article above ) has developed a speciality APP TO TRACK PAIN
As a patient, it’s important to be able to remember and adequately describe your pain to your healthcare provider. Pain is a complex sensation that can constantly change with varying intensities, textures, locations, and patterns of spread. Keeping track of all of the complex changes that can occur from day-to-day is a daunting task! This is especially true for individuals who suffer from a severe type of chronic pain called Complex Regional Pain Syndrome (CRPS) — aka, Reflex Sympathetic Dystrophy (RSD).
Until now.
Using patent pending technology, Nanolume makes it easy to track your pain over time and share that information with your physicians.
ON SALE DURING NATIONAL CRPS AWARENESS MONTH FOR ONLY $2.99!
CLICK HERE TO VISIT THE NANOLUME WEBSITE and read more about it!
If you would like to contact Dr. Harbut at his new clinic, The Hot Springs Pain Institute, to be seen as a pain patient or for low-dose ketamine treatment, you can contact the clinic at (501) 651-4488 or Fax (501) 651-4490.
As a patient, it’s important to be able to remember and adequately describe your pain to your healthcare provider. Pain is a complex sensation that can constantly change with varying intensities, textures, locations, and patterns of spread. Keeping track of all of the complex changes that can occur from day-to-day is a daunting task! This is especially true for individuals who suffer from a severe type of chronic pain called Complex Regional Pain Syndrome (CRPS) — aka, Reflex Sympathetic Dystrophy (RSD).
Until now.
Using patent pending technology, Nanolume makes it easy to track your pain over time and share that information with your physicians.
ON SALE DURING NATIONAL CRPS AWARENESS MONTH FOR ONLY $2.99!
CLICK HERE TO VISIT THE NANOLUME WEBSITE and read more about it!
If you would like to contact Dr. Harbut at his new clinic, The Hot Springs Pain Institute, to be seen as a pain patient or for low-dose ketamine treatment, you can contact the clinic at (501) 651-4488 or Fax (501) 651-4490.
