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Thread: Ketamine

  1. #11
    I believe I must respectfully disagree with some of that.

    Patients who take medication for pain very rarely become addicted. Physically dependant, sure, but not addicted. People stealing it for a high - they can get addicted. Not generally pain patients.

    I am pretty sure Ketamine is widely used in veterinary anesthesia.

    From the Veterinary Anesthesia & Analgesia Support Group website:

    "NMDA ANTAGONISTS helps to prevent sensitization of the central nervous system, reducing the exaggerated pain response that is otherwise a potential development after any significant traumatic or surgical event[x]. NMDA antagonists enhance opioid analgesia and they help to combat the opioid tolerance that may occur when opioids are given for long periods of time.
    KETAMINE is the most commonly utilized veterinary NMDA antagonist.

    Your reference to American Veterinarian Association - I presume you mean the AVMA (American Veterinary Medical Association) - I would be very interested to see if they have some recommendation about Ketamine - I couldn't find it - do you have a link?

    There is recent research into using ketamine for pain control in humans. Some patients have been helped (even made pain-free) from ketamine comas. For example, Dr. Lubenow at Rush in Chicago is doing some work using ketamine (infusions I believe).

    I don't mean to say everyone should rush out and get ketamine, of course. But it does seem to have some promise in pain management, especially for difficult cases.

  2. #12
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    No link Tam, I just know.

  3. #13
    I just asked a veterinarian, who said it's still widely used, and he believes there is no AVMA statement against it that we're aware of. It's possible there is something, and I haven't found it.

    Just for interest, here is the link from my prior quote (sorry, I had forgotten before):

    http://www.vasg.org/ (veterinary anesthesia and alagesia support)

    Although it is veterinary, that site has a rather good write-up about pain (which is really no different in animals than in humans)

    Merck veterinary manual also says:

    http://www.merckvetmanual.com/mvm/in...&word=ketamine

    "Ketamine has long been known to provide excellent superficial analgesia but rather poor visceral analgesia. Recently, interest in ketamine has increased because of its potential role in preventing wind-up (sensitization) of central nociceptive pathways. Ketamine is an antagonist of the excitatory neurotransmitter glutamate at the N-methyl-D-aspartate (NMDA) receptors in the spinal cord and brain. Inhibition of the NMDA receptors prevents or decreases exaggerated pain states in laboratory animals and people. Thus, ketamine may be incorporated into the anesthetic protocol to prevent the development of exaggerated or chronic pain states. "

    Hope Bill doesn't mind this digression, but my point is that Ketamine is getting increased interest, both in animal and human pain research, due to its effect on NMDA receptors.

    Of course, the animals at times get things before the humans do, so it is often interesting to see what comes up in the veterinary world.

  4. #14
    i was given ketamine during a surgical procedure. upon awaking i was freaking out and was so panicky. i had a very hard time with this drug. it states that anxiety is a side effect from this drug. everyone acts differently to medications.. hopefully this wont be the case for you. plus i was told is a very old drug thats not used much for anesthesia any more. i dont know about pain management.

  5. #15
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    Tam, I'm not going to debate it because I have no written facts to paste & give you. I've just worked the field & have discussions with others still in it. I still have to disagree though that those with chronic pain can't become addicted. It's very easy especially with this drug because it can be so calming.

    duj,yes it can cause major anxiety & restlessness when wearing off. This is where I've seen the abuse take place(in a friend I worked with), she kept needing her fixes to then calm the anxiety caused by the rapid heartbeat down. It can be a viscious cycle. You should see the animals coming off of it, it's surprising they don't hurt themselves from freaking out so badly.

  6. #16
    Sent you a pm

    Pain management doses are generally significantly lower than anesthetic doses - generally wouldn't get the same/as many side effects.

    It is used less for anesthesia these days, but more for pain management.

  7. #17

    ketamine update

    can't say as anything is happening, had a decent morning didn't hit 9 til 2.

    the gorilla has moved and and brought a few friends, nice to have the company.

    I will note that i have had some very realistic and strange dreams last night but but certainly inconclusive.

    will continue the course, dose doubles monday and approaches where it should do something and no side effects so far.

    bill

  8. #18
    Hey, you can have your own virtual version of the three wise monkeys (gorillas)! Actually, I once knew a guy who had a keyring with four moneys lolol

    I'm glad there are no bad effects - I hope the relatively good morning portends things to come.

    Fingers cross yet again for monday.

  9. #19
    Tam

    You said:

    pain (which is really no different in animals than in humans)

    I totally agree and therefore what applies to humans should apply to animals and vice versa, ALTHOUGH we do have to dispose of some skeptics and alternative points of view. To illustrate.....

    When I was a little kid I had this very mild cocker spaniel, nicest dog ever. I accidentally got paint on him and so i poured gasoline on him to get it off. He freaked out and started howling and running around frantically. Now this pet dog bit me when I tried to wash off the gasoline. It was really getting scary until I sat him down and explained to him about the mind/body connection. I also explained he was only reacting this way for SECONDARY GAIN. When I educated him, his pain magically went away, and was he ever EMBARASSED to think he had done this to himself.

    Just to be nice, I did not charge the dog my normal 600 dollar fee for telling him about mind/body and secondary gain. After that, I could literally drench him in gasoline any time I wanted and he was perfectly happy. If you have a large pit bull I recommend you repeat this experiment. Pour gasoline all over the dog, and when he begins to writhe, put your face next to his and educate him. Pit bulls are very intelligent and readily understand the concepts of mind/body, even if you don't. (do not actually do this, gasoline burns animals)

    Of course, such a story would be ludicrous for animals, but there is a fairly large bunch of professionals who strongly advocate that humans are not like animals and that we IMAGINE things. For example, I imagine that I am really burning right now. If only I had my mind/body book. How could I have been so careless.
    __________________________________________________ _____________


    P.S. I have never heard of anyone becoming addicted to ketamine, but quad79 probably knows better. Here is a cite Addiction. 2009 Nov 12 which mentions concerns about depression and cognitive function but did not report addiction, so who knows. Anxiety happens. It happened to me on huge doses of steroid (for the facet) and also when I stopped elavil. It is very uncomfortable, but if you just tell yourself you are going to be loooney for five days, you will not crave it. Nowadays people know it vital to taper off such drugs slowly to avoid seizures, but this is not the same thing as addiction.

    Saying a drug is an NMDA antagonist is a synonym for saying, " We don't know how pain works, so NMDA (an excitatory chemical process) is as good an explanation as any". Ten years ago they knew all about NMDA, Now, they know nothing. NMDA is also invoked as an explanation for memory change, and many other mysterious things which require you to fill in the blank on the FDA form, when it asks for mechanism of action of a new drug. It gets embarassing after a while so they sometimes alternate with "affects serotonin, dopamine, or muscarinic adrenergic receptors" They still don't know how pain works, but this stuff sounds likely, and usually draws a pass. ACtually, NMDA is an important receptor on the post synaptic side, but it is just SOOO hard to figure out what it is doing in pain. yeah, it moves with calcium, but then what? Sort of like looking at the Mona Lisa and speculating about what is on her mind.

    CERN is restarting right now, and they hope to discover two things:
    1) the fundamental nature of matter
    2) a drug which does NOT affect the NMDA receptor.


    P.S. If anyone on this forum knows how pain works, please post. I am curious, because it really burns and I wish to stop biting people.

    P.P.S. Bollefen, If I were a betting man, I would bet that if they keep doubling your ketamine you WILL notice something, and then, soon enough, WONT notice anything. It is an anesthetic. Keep us posted and good luck. I like your posts except they are sad, unlike my gloriously positive ones, so typical for severe central pain. When I am not beginning one new highly ineffective drug for central pain, why, I am detoxing from another one equally ineffective. My prior pain doctor sounded like he went to medical school in Alice in Wonderland. Of course my description of my pain probably struck him that way, as well. If you hve never tasted sugar, salt won't reveal its nature, If all you have experienced is normal pain, you don't get central pain, at all. For those dying to find out, there is always capsaicin injection, which will give you ONE component of nerve injury pain for a brief time. Since time is a very big factor in pain, you still won't have it.
    Last edited by dejerine; 11-22-2009 at 05:53 AM.

  10. #20
    Dejerine, fascinating post (as always).

    Ah yes, the joy of dealing with physicians when you are in pain. My husband has a pain doctor who is a pain patient himself - most patients are not so lucky. Not that I wish it on anyone, including our doc - but he does understand.

    Great analogy with the dog story (poor doggy, but I'm sure he forgave you).

    Re. the ketamine - I have no idea if the drug is potentially addictive. But the point I was trying to make was that statistically, people who take drugs for pain, be they opiates or other medications that can be addictive, generally do NOT get addicted. Of course, a small percentage does, and those who have a history of addiction have to be more careful. But fear of addiction shouldn't, imo, be a reason to not try medications that might offer pain relief.

    Your comments re. NMDA antagonists - very interesting. I'll have to do some research. The drugs that (supposedly?) are NMDA antagonists do seem to work for some anyway, so I guess that's a good thing.

    LOL re. the biting people. I vote you do not stop, it sounds like a very productive and useful habit. Lately, I very much feel like biting quite a few people. I wonder if it would create the desired attitude adjustment...

    I hope you find something that works. I am sorry.

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