Safe and Effective Treatment of Refractory Cancer Pain with Chronic Oral Ketamine: A Case Series
Introduction: A growing body of evidence supports the off-label use of subanesthetic or low-dose oral ketamine for chronic pain. However, the safety and efficacy of long-term treatment remain unclear. This case series describes one palliative care (PC) clinic’s experience using long-term oral ketami...
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| Language: | English |
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Mary Ann Liebert
2024-10-01
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| Series: | Palliative Medicine Reports |
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| Online Access: | https://www.liebertpub.com/doi/10.1089/pmr.2024.0049 |
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| author | Dmitry Kozhevnikov Lava Kareem Trinh Bui |
| author_facet | Dmitry Kozhevnikov Lava Kareem Trinh Bui |
| author_sort | Dmitry Kozhevnikov |
| collection | DOAJ |
| description | Introduction: A growing body of evidence supports the off-label use of subanesthetic or low-dose oral ketamine for chronic pain. However, the safety and efficacy of long-term treatment remain unclear. This case series describes one palliative care (PC) clinic’s experience using long-term oral ketamine to treat refractory cancer pain. Methods: All patients (n = 3) treated with oral ketamine in one PC clinic between 2022 and 2024 for adult cancer pain were reviewed. Pain scores were collected using the Edmonton Symptom Assessment Scale numeric rating scale as part of routine follow-up visits. Results: All patients reported improvement in cancer-related pain with the addition of oral ketamine. The total daily dose ranged from 30 mg to 320 mg. One patient experienced mild dissociative effects and dizziness, which resolved after decreasing the total daily dose. Treatment was maintained beyond 3 months in 2/3 cases, and the longest course of therapy was 18 months. The most significant logistical challenge was related to supply chain issues limiting availability at community pharmacies. Conclusion: Chronic treatment with oral ketamine as a coanalgesic for refractory cancer pain was well tolerated. All patients reported improved pain scores with the addition of oral ketamine. Ongoing research is needed to further describe the risks and benefits of long-term oral ketamine treatment. |
| format | Article |
| id | doaj-art-bf6a101e34644ea2b6cbe5da856cc4ee |
| institution | OA Journals |
| issn | 2689-2820 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Palliative Medicine Reports |
| spelling | doaj-art-bf6a101e34644ea2b6cbe5da856cc4ee2025-08-20T01:50:56ZengMary Ann LiebertPalliative Medicine Reports2689-28202024-10-015147548010.1089/pmr.2024.0049Safe and Effective Treatment of Refractory Cancer Pain with Chronic Oral Ketamine: A Case SeriesDmitry Kozhevnikov0Lava Kareem1Trinh Bui2Yale Palliative Care Program, Yale School of Medicine, New Haven, Connecticut, USA.Smilow Cancer Hospital, Yale New Haven Hospital, New Haven, Connecticut, USA.Yale Palliative Care Program, Smilow Cancer Hospital, Yale New Haven Hospital, New Haven, Connecticut, USA.Introduction: A growing body of evidence supports the off-label use of subanesthetic or low-dose oral ketamine for chronic pain. However, the safety and efficacy of long-term treatment remain unclear. This case series describes one palliative care (PC) clinic’s experience using long-term oral ketamine to treat refractory cancer pain. Methods: All patients (n = 3) treated with oral ketamine in one PC clinic between 2022 and 2024 for adult cancer pain were reviewed. Pain scores were collected using the Edmonton Symptom Assessment Scale numeric rating scale as part of routine follow-up visits. Results: All patients reported improvement in cancer-related pain with the addition of oral ketamine. The total daily dose ranged from 30 mg to 320 mg. One patient experienced mild dissociative effects and dizziness, which resolved after decreasing the total daily dose. Treatment was maintained beyond 3 months in 2/3 cases, and the longest course of therapy was 18 months. The most significant logistical challenge was related to supply chain issues limiting availability at community pharmacies. Conclusion: Chronic treatment with oral ketamine as a coanalgesic for refractory cancer pain was well tolerated. All patients reported improved pain scores with the addition of oral ketamine. Ongoing research is needed to further describe the risks and benefits of long-term oral ketamine treatment.https://www.liebertpub.com/doi/10.1089/pmr.2024.0049cancer painlow dose ketamineoral ketaminepalliative medicinerefractory pain |
| spellingShingle | Dmitry Kozhevnikov Lava Kareem Trinh Bui Safe and Effective Treatment of Refractory Cancer Pain with Chronic Oral Ketamine: A Case Series Palliative Medicine Reports cancer pain low dose ketamine oral ketamine palliative medicine refractory pain |
| title | Safe and Effective Treatment of Refractory Cancer Pain with Chronic Oral Ketamine: A Case Series |
| title_full | Safe and Effective Treatment of Refractory Cancer Pain with Chronic Oral Ketamine: A Case Series |
| title_fullStr | Safe and Effective Treatment of Refractory Cancer Pain with Chronic Oral Ketamine: A Case Series |
| title_full_unstemmed | Safe and Effective Treatment of Refractory Cancer Pain with Chronic Oral Ketamine: A Case Series |
| title_short | Safe and Effective Treatment of Refractory Cancer Pain with Chronic Oral Ketamine: A Case Series |
| title_sort | safe and effective treatment of refractory cancer pain with chronic oral ketamine a case series |
| topic | cancer pain low dose ketamine oral ketamine palliative medicine refractory pain |
| url | https://www.liebertpub.com/doi/10.1089/pmr.2024.0049 |
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