Bot Detector
IJPC Seal
Download FREE Sample Issue or Article
LEARN MORE
Subscribe Today
A subscription to IJPC includes a print copy delivered by postal mail and on-line access to electronic PDF copies of your subscribed issues.

Topical Ketamine in the Treatment of Complex Regional Pain Syndrome

Author(s):  Durham Melissa J, Mekhjian Hovik S, Goad Jeffery A, Lou Mimi, Ding Michelle, Richeimer Steven H

Issue:  Mar/Apr 2018 - Volume 22, Number 2
View All Articles in Issue

Page(s):  172-175

Download in electronic PDF format for $65

Abstract:  The purpose of this study was to evaluate the effectiveness and adverse effects of topical ketamine in the treatment of complex regional pain syndrome. Retrospective charts were reviewed of patients 18 years or older diagnosed with complex regional pain syndrome and treated with topical ketamine during the study period of May 2006 to April 2013 in an academic medical center specialty pain clinic. Exclusion criteria consisted of subjects who 1) were treated with topical ketamine for pain syndromes other than complex regional pain syndrome, 2) initiated other pain therapies concurrently with topical ketamine, 3) had less than two documented visits, 4) began use of topical ketamine prior to the start of the study period, 5) were under 18 years of age. Subjects with ICD-9 diagnoses codes complex regional pain syndrome-1 or complex regional pain syndrome-2 were identified from encounter-based data and billing records. Data collected for each subject included demographics, description of complex regional pain syndrome, concurrent medications and medical conditions, type of ketamine compound prescribed, duration of therapy, side effects, reasons for discontinuation (if any), and pain scores (numerical pain rating scale; 0 to 10). Data were analyzed using descriptive statistics. Institutional Review Board approval was obtained prior to initiating the study. Sixteen subjects met the inclusion/exclusion criteria for the study, 69% of which were female with an average age of 46 years (range: 24 to 60). Subjects took an average of 3.7 other pain medications (range: 2 to 8), had an average of 2.7 other co-morbid pain conditions (range: 1 to 5), and 1.6 other co-morbid non-pain conditions (range: 0 to 4). Eight (50%) reported that their pain had improved, while 7 (44%) reported a worsening of pain. One reported no change in pain score. No subjects reported adverse effects. Based on the findings in this study, the use of topical ketamine in the treatment of complex regional pain syndrome shows promise due to the overall limited options available to treat this condition, as well as the favorable safety profile of topical agents. Future prospective controlled studies are needed to demonstrate a clear benefit.

Related Keywords: Melissa J. Durham, PharmD, MACM, Hovik S. Mekhjian, PharmD, Jeffery A. Goad, PharmD, MPH, Mimi Lou, MS, Michelle Ding, PharmD, MS, Steven H. Richeimer, MD, ketamine, complex regional pain syndrome, topical preparations, CRPS, reflex sympathetic dystrophy syndrome, RSDS, nerve injury, pain relief, analgesia, analgesic, NMDA antagonist, glutamate, drug safety, pain intensity scores, formulations

Related Categories: PAIN MANAGEMENT, PEER-REVIEWED, ADVERSE DRUG EVENTS, DOSAGE FORMS/DRUG CARRIERS, NEUROLOGY

Printer-Friendly Version



Related Articles from IJPC
Title/Author
(Click for Abstract / Details)
Issue/​Page
View/Buy
Topical Ketamine in the Treatment of Complex Regional Pain Syndrome
Durham Melissa J
, Mekhjian Hovik S, Goad Jeffery A, Lou Mimi, Ding Michelle, Richeimer Steven H
Mar/Apr 2018
Pg. 172-175

Buy
Oral Methadone for Management of Regional Sympathetic Dystrophy Syndrome: A Case Revisited
Vail Jane
May/Jun 2007
Pg. 187-192

Buy
Low-Dose Naltrexone: A New Therapy Option for Complex Regional Pain Syndrome Type I Patients
Sturn Kayla M
, Collin Michael
May/Jun 2016
Pg. 197-201

Buy
Novel Approaches to Topical Psoriasis Therapy
Koyama Gregory
, Liu Jenny, Scaffidi Alyse, Khazraee Maryam, Epstein Benjamin
Sep/Oct 2015
Pg. 357-365

Buy
Using Compounded Medications for the Topical Treatment of Complex Regional Pain Syndrome Type I Following Trauma: A Case Report
Zur Eyal
Jan/Feb 2014
Pg. 14-19

Buy
Incorporating Quality Assurance in Pharmaceutical Compounding-related Courses in the PharmD Curricula
Hossain Mohammad Faisal
, Levesque Dan, Frye John, Rashid Mamoon
Jul/Aug 2020
Pg. 322-326

Buy
Finding the Right Balance: A Nationwide Study of Student Pharmacist Exposure to and Perceptions of Nonsterile Compounding
Fredrickson Mary E
, Belcher Faith G, Del Vecchio Kamryn N, Galleher Miranda N, Jugo Leila S, Gothard M David, Pallotta Raneem H, Pallotta Victor A Jr
May/Jun 2022
Pg. 242-247

Buy
Efficacy and Clinical Value of Commonly Used Ingredients in Pain Management Compounds: A Literature Review
Beshay Sarah M
, Rivera Gerard, Balthasar Jan, Florea Naomi
Jul/Aug 2015
Pg. 295-300

Buy
Compounded Analgesic Therapy for Disorders of Movement: Arthritis, Neuropathic Pain, and Postpolio Syndrome
Brown Scott
, Erickson Brian, Muller George, Bryant-Snure Susan J, Mestayer Richard F III
May/Jun 2010
Pg. 182-192

Buy
Topical Ketamine: A Review of the History, Mechanisms, Uses, Safety, and Future
Rabi Joseph
Mar/Apr 2016
Pg. 107-113

Buy
Particle Measuring Systems - USP <797> Environmental Monitoring Solutions