Each year, American workers miss over 113 million workdays due to migraines, making the chronic illness the sixth most debilitating in the world. More than mere headaches, migraines often cause intense pain, hypersensitivity, and nausea, among other symptoms. These impacts make it impossible for 90% of sufferers to function normally in the midst of an attack.
But despite these staggering statistics, migraines are notoriously difficult to treat. There is no known cure, and management can involve testing a slew of medications and lifestyle changes. However, recent research suggests that relief may come from an unexpected source: a medication called ketamine.
Ketamine and Migraines
Used medically as an anesthetic and pain medication as an alternative to narcotics, ketamine may soon be used to treat migraine sufferers. A recent study showed that 75% of patients tested experienced significant pain relief from between three and seven days of ketamine treatment. Another research group found that treatment with a ketamine nasal spray reduced the severity of aura (sensory disturbances that often precede or accompany migraines). A third showed that outpatient ketamine treatment cut pain levels in half across five groups of migraine sufferers. While these studies have limitations, they suggest a promising avenue of research for migraine relief.
How Does it Work?
Given these results, it’s worth asking why ketamine has been successful in treating some migraine pain. Unfortunately, we don’t know. We do know that ketamine acts on a certain type of receptor in the brain called the NMDA receptor, and that blocking this structure changes the way the brain forms connections. The link between this biological mechanism and the observed pain relief, though, is less clear. Research is ongoing, as the answer may lead to insights into medical conditions ranging from depression and OCD to chronic pain.
Where Do We Go From Here?
While some headache specialists use ketamine off-label for their migraine patients, researchers caution that ketamine is not ready to be used extensively yet. It also had not yet been approved by the FDA, although that mainly implies a need for further testing. Concerns include the potential for side effects, including psychoactive effects such as an “out of body experience”, along with questions about how long the treatment lasts.
Still, the preliminary data shows that migraine patients have good reason to be hopeful. Ketamine appears to treat symptoms and has other benefits, such as lacking the same addictive qualities as opiate alternatives. With more rigorous testing, ketamine may well become a valuable tool in the fight against intractable migraines.