1 Jun 2023 • A recent study published in BMJ's Regional Anesthesia & Pain Medicine Journal suggests that nasal ketamine spray may hold promise as a safe and effective treatment option for refractory chronic migraine patients. Traditional intravenous ketamine infusion has shown efficacy in treating chronic headache disorders. To investigate the viability of nasal ketamine spray as an alternative, researchers conducted a retrospective review of patients treated at a a single tertiary headache center.

During the study period, 242 individuals were prescribed nasal ketamine spray. Candidates who received intranasal ketamine between January 2019 and February 2020 were screened through an electronic medical record query. Intranasal ketamine was reported as ‘very effective’ in 49.1% and the quality of life was considered ‘much better’ in 35.5%. At the time of the interview, 65.1% remained current intranasal ketamine users and 74.0% reported at least one adverse event including fatigue, double/blurred vision, and cognitive effects such as confusion or dissociation.

In this descriptive study, intranasal ketamine served as an acute treatment for refractory chronic migraine by reducing headache intensity and improving quality of life with relatively tolerable adverse events. Most patients found intranasal ketamine effective and continued to use it despite these adverse events.

However, well-designed prospective placebo-controlled trials are necessary to demonstrate the efficacy and safety of intranasal ketamine in patients with migraine. The optimal dosage and clinical guidelines for nasal ketamine spray in migraine treatment also remain to be determined.

Source: BMJ | Read full story