AUTHOR=Al Mukhaizeem Sammy , Nasa Anurag , Waldron Dympna , McDaid Alex , Gorman Patrick J. , Featherstone Molly , Barry Megan , Murphy Paul , Gallagher Hugh , Nair Shrijit , O’Connor Michael , Kelly Linda , O'Hora Emma , Dolan Roisin , Mac Colgain Siaghal , McGrath Jack , Blouin Stephane , Roman Elena , Gaffney Laura , Roddy Darren William , Levins Kirk John TITLE=Investigating the effectiveness of oral ketamine on pain, mood and quality of life in treatment resistant chronic pain JOURNAL=Frontiers in Pain Research VOLUME=4 YEAR=2023 URL=https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2023.1268985 DOI=10.3389/fpain.2023.1268985 ISSN=2673-561X ABSTRACT=Introduction

Chronic pain is defined as pain lasting longer than 3 months. This often causes persistent emotional distress and functional disability that is refractory to conventional treatments. Emerging evidence suggests that oral Ketamine therapy may have a specific role in managing treatment-resistant chronic pain. This study aimed to assess the effectiveness of oral ketamine within a tertiary chronic pain management clinic.

Methods

This study was a clinic-based retrospective descriptive study of 79 patients with a broad range of chronic pain diagnoses and treated with oral ketamine over a period up to 12 years. Changes in pain, mood and quality of life (QoL) were assessed using a numerical pain severity score, the Brief Pain Inventory (BPI), the Public Health Questionnaire (PHQ-9) and American Chronic Pain Association Quality of Life (QoL) scale.

Results

73 patients were accessible for follow-up (mean daily dose and treatment duration were 193.84 mg and 22.6 months respectively). Pain scores decreased (p < 0.0001) on both numerical scores (41.6% decrease) and BPI scoring (mean decrease 2.61). Mood improved (p < 0.0001) across both PHQ-9 and BPI measurements. Patients also reported less difficulty with daily activities and improved QoL. The most common adverse reaction was drowsiness (21.9%), with 30.1% reporting no adverse reactions from Ketamine.

Discussion

This work adds to the growing body of evidence that under the supervision of a pain specialist, oral ketamine therapy may be a safe, tolerable and effective treatment for chronic pain conditions which have not responded to other management options. Further research is required to produce a more accurate understanding of its chronic use.

Key message

This real-world study shows that patients being treated with oral ketamine for chronic pain report decreased severity of pain, improved mood and increased quality of life across all conditions.