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Ketamine Infusion Combined With Magnesium as a Therapy for Intractable Chronic Cluster Headache

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BACKGROUND Chronic cluster headache (CH) is a rare, highly disabling primary headache condition. As NMDA receptors are possibly overactive in CH, NMDA receptor antagonists, such as ketamine, could be of interest in patients with intractable CH.

CASE REPORTS Two Caucasian males, 28 and 45 years-old, with chronic intractable CH, received a single ketamine infusion (0.5 mg/kg over 2 h) combined with magnesium sulfate (3000 mg over 30 min) in an outpatient setting. This treatment led to a complete relief from symptoms (attack frequency and pain intensity) for one patient and partial relief (50%) for the other patient, for 6 weeks in both cases.

CONCLUSION The NMDA receptor is a potential target for the treatment of chronic CH. Randomized, placebo-controlled studies are warranted to establish both safety and efficacy of such treatment.

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  • 4 months later...

There have been some posts here, and some reports at conferences, about ketamine.  Here's a link to one, from a beloved CB member, "Ricardo."  https://clusterbusters.org/forums/topic/4780-ketamine-conference-talk/#comment-50317  You can probably find more by putting ketamine into the search box, top right side of the page.

FWIW, there's a pharma drug, rapastinel, not yet on the market but due fairly soon (next year or two), that works on ketamine receptors without ketamine side effects.  So, far, in extensive clinical trials (not for CH, but for depression), zero side effects, period.  I have some high hopes for this, though it might, please Lord, be surpassed in efficacy and sooner availability by the monoclonal antibodies currently being tested with what seems to be good promise against migraine and CH.  https://en.wikipedia.org/wiki/Rapastinel


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  • 1 month later...

Seems that more clinical trials are being undertaken, which will be completed this year, after which the company can request FDA approval.  Unfortunately, this is an injection that has to be administered in a doctor's office, so it might take a very adventurous doc to try it for CH (although I guess studies of the effects of ketamine on CH might encourage this "off label" use).  Pills are supposed to be available not long afterward, though.

Seems like there are also some other ways of delivering ketamine being looking into, also. See "United States" on this page.

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