Intranasal ketamine seems effective for refractory chronic migraine, with about half of patients reporting it as very effective, according to a study published online May 30 in Regional Anesthesia & Pain Medicine.
Hsiangkuo Yuan, M.D., Ph.D., from Thomas Jefferson University in Philadelphia, and colleagues conducted a retrospective study at a single tertiary headache center to examine the clinical effectiveness and tolerability of intranasal ketamine for refractory chronic migraine. A total of 242 patients received intranasal ketamine between January 2019 and February 2020; 169 were interviewed.
The researchers found that the participants reported a median of 30 monthly headache days and tried four classes of preventive medications. Patients used six sprays per day overall, for a median of 10 days per month. In 49.1 percent of patients, intranasal ketamine was reported as very effective, and in 35.5 percent, quality of life was considered much better. At the time of the interview, 65.1 and 74.0 percent remained current users of intranasal ketamine and reported at least one adverse event, respectively.
“This retrospective study suggests that intranasal ketamine may offer a pain-relieving effect with limited morbidity for refractory chronic migraine in the outpatient setting,” the authors write. “The optimal intranasal ketamine dosage, however, remains to be explored.”
Several authors disclosed ties to the biopharmaceutical industry.
