Journal of pain & palliative care pharmacotherapy
March 1, 2025
Miranda Hetrick, Emily Casey, Jacob Radcliff et al.
2 citations
Oral ketamine was administered safely for pain control in hospitalized patients, with a low incidence of safety events. The median starting dose was 1 mg/kg/day and the median maximum dose was 1.6 mg/kg/day. Median oral morphine equivalent doses decreased from the first to the last day of therapy. The study population included adults at a large academic hospital, many of whom may have had high opioid tolerance or opioid-induced hyperalgesia. The findings suggest oral ketamine is a safe analgesic option, though further research on efficacy and safety is needed.
Journal of pain & palliative care pharmacotherapy
December 1, 2024
Leslie Siegel, Kyle Quirk, Gary Houchard et al.
2 citations
Among 105 adults with cancer pain treated with subanesthetic ketamine, 48.6% responded—achieving a 30% reduction in pain score, as-needed opioid use, or total morphine equivalent daily dose. Responders received lower fixed-rate doses (median 15 mg/hr) than non-responders (median 15–20 mg/hr), but weight-based doses did not differ between groups (0.201 vs. 0.209 mg/kg/hr). Responders had higher baseline opioid needs. The findings suggest weight-based dosing may not improve success over fixed-rate dosing, though the study was underpowered.
Journal of pain & palliative care pharmacotherapy
April 30, 2025
André Luis Vieira Drumond, Lucas Nunes Bandeira de Melo, Marina Ayres Delgado
1 citation
A 63-year-old man suffered debilitating chronic pain for five years after inguinal hernia repair, despite treatments including amitriptyline, gabapentin, codeine, nerve blocks, and acupuncture. Periodic intravenous infusions of 30 mg of ketamine every 30 days substantially relieved his pain, improved mobility, and enhanced daily function. Ketamine, an NMDA receptor antagonist, may help by modulating central sensitization. This case supports the 2018 consensus guidelines on ketamine for chronic pain and adds evidence for its use in chronic postsurgical pain, though more research is needed to establish optimal protocols.
Journal of pain & palliative care pharmacotherapy
May 29, 2026
Yogendra Singhal, Pavan Gaurav R, Sreeharsh Saji et al.
Depression is common among cancer patients and harms quality of life, treatment adherence, and prognosis. Standard antidepressants take weeks to work, but ketamine may offer rapid relief. This systematic review of 14 studies (randomized trials, cohort studies, and case-control designs) found that ketamine quickly reduces depressive symptoms, often within hours to days, and also improves anxiety, pain, and quality of life. Short-term side effects include fatigue, dizziness, and dissociation; long-term safety data are limited. Ketamine appears promising as a short-term option for depression in cancer patients, especially those with treatment-resistant depression, but more research is needed on long-term outcomes and optimal dosing.
Journal of pain & palliative care pharmacotherapy
June 1, 2025
Nathan Smith, Sanny Juresic, Kia Lor et al.
A case series of three patients with complex medical histories experienced improved postoperative pain relief when intravenous magnesium sulfate was given together with ketamine. Both drugs block NMDA receptors, which are involved in pain signaling. The report describes difficulties in managing pain after surgery in these patients and notes the beneficial effect of adding magnesium to ketamine. The authors call for more research to determine which patients benefit most and what doses work best.