Current pain and headache reports
January 7, 2025
Natalie H Strand, Madeline Whitney, Brooks Johnson et al.
9 citations
Chronic pain affects about 1.5 billion people worldwide and is a leading cause of disability. Conventional treatments like opioids and NSAIDs often cause adverse effects and limited long-term relief. This review examines psychedelics—psilocybin, LSD, and ketamine—as alternative therapies. These substances modulate pain through serotonergic and glutamatergic systems and may promote neuroplasticity. The review covers their pharmacologic actions, effects on cancer pain, migraines, and neuropathic pain, and clinical implications, highlighting the need for further research to validate efficacy and optimize use.
Current pain and headache reports
September 1, 2023
Emmanuelle A. D. Schindler
7 citations
A review of existing literature proposes a framework for using psychedelic drugs as therapeutic agents in episodic migraine. In the only clinical trial of a psychedelic drug for migraine, a single low dose of psilocybin reduced weekly migraine days and pain intensity for two weeks in episodic subjects. Transitional effects, along with abortive effects in two subjects and findings in cluster headache, suggest potential medicinal use. Evidence supports continued investigation of psilocybin and other psychedelics as transitional treatments, though acute and preventive applications may have risks that outweigh benefits. Future research should be tailored for migraine, not modeled after other conditions.
Current pain and headache reports
January 14, 2025
Alan D Kaye, Brynne E Tynes, Coplen D Johnson et al.
6 citations
Complex Regional Pain Syndrome (CRPS) is a chronic pain condition where pain is much greater than expected from the initial injury and lasts a long time. Many standard treatments have been unsatisfactory. Ketamine, a drug that blocks NMDA receptors and is normally used for anesthesia and pain relief, shows promise for CRPS patients who do not respond to usual therapies. Multiple studies report significant improvements in pain severity, limb mobility, and other measures after ketamine infusion. Side effects such as nausea, vomiting, headache, or psychotropic symptoms were uncommon and reversible by stopping the drug. More research is needed on optimal dosing and duration, but ketamine appears safe and effective for difficult CRPS cases. This review summarizes current knowledge on ketamine infusions for CRPS to help physicians weigh benefits and risks.
Current pain and headache reports
January 16, 2025
Isabella Henderson, Ronnie Elsaadany, Gabriel Chan et al.
4 citations
Serotonergic psychedelic drugs like psilocybin and LSD show promise as treatments for headache disorders, including migraine and cluster headache. Some patients who underwent brief treatment periods experienced reduced headache attack frequency, severity, or duration. When prescription medications are ineffective or habit-forming, patients often turn to these alternatives. This review assesses the literature on mechanisms, safety, and efficacy, emphasizing that physicians should be well-informed to advise patients who self-treat. Further research is needed, including combining psychedelics with psychotherapy like cognitive behavioral therapy.
Current pain and headache reports
June 19, 2025
Elika D Javaheri, Christopher Wie, Stephen Covington et al.
3 citations
High-dose ketamine, used for conditions like Complex Regional Pain Syndrome, is linked to several adverse effects. Psychiatric symptoms such as agitation, anxiety, and sleep disturbances occur across oral, intravenous, and intranasal routes. Emesis is common and more frequent at higher doses. Hepatotoxicity is also common, dose-dependent, and usually transient. Uropathy is another potential adverse effect. When properly monitored in a hospital setting, high-dose ketamine appears safe, though practitioners should note that certain adverse effects are likely dose-dependent.
Current pain and headache reports
December 15, 2025
Alan D Kaye, Madison C Wolf, Sarah I Dufour et al.
2 citations
Ketamine, an NMDA receptor antagonist, shows promise as an adjunctive treatment for patients with both chronic pain and opioid use disorder. It blocks NMDA receptors, reducing neural excitability and promoting neuroplastic changes that may help manage pain and reduce opioid dependence. Clinical studies suggest ketamine can reduce pain severity, decrease opioid consumption, and alleviate withdrawal symptoms in select populations. However, evidence is limited by small sample sizes, non-standardized protocols, and short follow-up periods. Side effects include dissociative symptoms, sympathomimetic activity, and potential for misuse, requiring careful patient selection and monitoring. Ketamine is a promising option in multimodal care when conventional therapies fail, but further research is needed.
Current pain and headache reports
November 1, 2024
Deng Biao, Kuyikabasi Umoh, Cao Qiguang et al.
2 citations
Mindfulness therapy improves pain-related functions in chronic pain, but its effectiveness may depend on psychosocial factors, as some studies question it. The therapy influences cognitive factors like thought inhibition, attention deficit, pain catastrophizing, and self-efficacy. It may normalize psychological and neural processes, increasing connectivity in networks related to stress, cognition, and emotion. Further research is needed to fully understand these effects, offering new directions for psychotherapy in chronic pain.
Current pain and headache reports
April 30, 2025
Neveen A Kohaf, Tabia Imtiyaz Khan, Hamada Hamdy Elbana et al.
1 citation
Nebulized ketamine offers a promising alternative for pain management, providing rapid absorption and effective delivery with potentially fewer side effects and better patient compliance due to the smaller volume required for nebulization. A systematic review of nine primary studies indicates that nebulized ketamine is a safe and efficacious treatment for acute pain. However, the evidence is still emerging, and further research is needed to understand its pharmacokinetics, optimal dosing, and efficacy across different populations.
Current pain and headache reports
April 21, 2026
Navy C Coggins, Hanson A Chokr, Tricia A Meyer et al.
Ketamine, originally developed as a dissociative anesthetic, has expanded beyond procedural sedation to pain management and psychiatry. In pain medicine, its therapeutic rationale is grounded in noncompetitive antagonism of the NMDA receptor and modulation of central sensitization, key mechanisms underlying refractory neuropathic and centralized pain states. Evidence from preclinical studies and randomized clinical trials suggests intravenous ketamine may provide short-term analgesic benefit for resistant neuropathic pain, phantom limb pain, and complex regional pain syndrome. Low-dose perioperative administration has demonstrated opioid-sparing effects as part of multimodal analgesia.