Ketamine nasal spray for refractory migraine may prove safe and effective

Ketamine taken in the form of a nasal spray may prove a safe and effective treatment for refractory chronic migraine, suggests a single centre study, published in the open access journal Regional Anesthesia & Pain Medicine.

The researchers retrospectively reviewed the outcomes and experiences of people given nasal ketamine spray for chronic refractory migraine between January and February 2020 at one single specialist headache centre.

During this period, 242 people were prescribed a nasal ketamine spray, 169 of whom agreed to be interviewed.

Forty one (25%) and 46 (28%) patients were offered nasal ketamine spray before and after intravenous ketamine infusion, respectively; 47% never received intravenous ketamine.

Overall, they said they used the nasal spray 6 times, over an average of 10 days a month. Nearly half (49%) said the spray was “very effective” while 39.5% found it “somewhat effective.” Over a third (35.5%) said their quality of life was “much better.”

Compared with other reliever drugs, 73 (43%) thought the nasal spray was “much better” and 50 (29.5%) felt it was “somewhat better.”

Almost three quarters said they used fewer pain reliever meds when using nasal ketamine spray. At the time of the interview, almost two thirds (65%) were still using the spray.

Reference:

Real-world study of intranasal ketamine for use in patients with refractory chronic migraine: a retrospective analysis,Regional Anesthesia and Pain Medicine,DOI: 10.1136/rapm-2022-104223