Complex regional pain syndrome (CRPS) is a painful debilitating neurological condition that accounts for approximately 1.2% of the adult chronic pain population. Patients with CRPS have pain, impairment of motor function, limitations in range of motion, and an exaggerated response to painful stimuli. Most cases of CRPS develop after a traumatic injury, such as a sprain, fracture, crush injury, or surgery. However, some cases of CRPS develop spontaneously with no known cause. The treatment for CRPS has traditionally been steroids, such as prednisone, and narcotic pain medication, like morphine. Unfortunately, opioid pain medications come with their own problems, including high risk for addiction, tolerance, nausea, vomiting and respiratory depression.
The good news is that in recent years, researchers have found that ketamine, a drug traditionally used as an anesthetic, has significant impact in reducing pain in CRPS. Research has shown that prolonged painful stimulus causes a large release of glutamate, a neurotransmitter, in the brain via the spinal cord. This release of glutamate in the brain stimulates, or ‘turns on,’ NMDA receptors, which in turn produces the feeling of pain, the main symptom of CRPS. Ketamine is a NMDA-receptor blocker, meaning that it has the ability to block this cascade and lessen the sensation of pain. You can think of it like a computer reboot –ketamine infusions essentially reset the pain connections from the brain to the body, decreasing the amount of pain that you feel.
Recent research has shown that low-dose ketamine infusions are successful in reducing painful sensations caused by CRPS. Multiple studies have found that ketamine infusions significantly decrease pain (greater than 50% decrease) in CRPS patients, with effects lasting up to 3 months. Long-term studies are still being conducted, so there is limited data showing how well ketamine infusions work for chronic pain-control in CRPS. Ketamine for CRPS is considered an off-label treatment, meaning that it is not FDA approved.
Ketamine infusions are also used as a potent antidepressant, and have been found to quickly and robustly decrease suicidal symptoms, as well as boosting mood and functionality in patients with treatment-resistant depression. Ketamine for depression is supported by extensive research, and is an off-label treatment. If you have CRPS and/or depression and want to manage your pain symptoms without experiencing the negative effects associated with opioid medication, talk to your doctor today about ketamine infusions!
Principium Psychiatry is a cutting edge treatment center for depression, anxiety, and related disorders in NYC. Principium offers four convenient locations; two offices in Manhattan, one near Grand Central Station and another office along Wall Street. In addition, we have an office in Greenwich Connecticut and Santa Monica California. Led by Ziv E. Cohen, M.D., a Clinical Assistant Professor of Psychiatry at Weill Cornell Medical College and a Fellow of the American Psychiatric Association, Principium Psychiatry offers an array of treatments for depression in NYC, including psychotherapy, psychopharmacology, Ketamine, and TMS.
