Combining IV and oral ketamine to treat chronic non-cancer pain
WorkSafeBC Evidence-Based Practice Group, Martin CW
Record ID 32018014873
English
Authors' objectives:
To determine whether there is any evidence on the efficacy or effectiveness of combining intravenous (IV) and oral ketamine, especially with a specific dosing of three days per week of IV ketamine, then followed by oral ketamine in a decreasing dose in treating patients with chronic pain or Complex Regional Pain Syndrome (CRPS).
Authors' results and conclusions:
381 published studies were identified from the literature searches. Upon examination on the titles and abstracts of these 381 published studies, two published studies were retrieved in full for further appraisal. Fourteen published studies were added from manual searches. Overall, 16 published studies were retrieved in full and appraised in this systematic review. Of the 16 studies that were retrieved in full, none provided any data relevant to the objective of this systematic review. Experts warned of the potential adverse events associated with the administration of IV or oral ketamine. Adverse events included urological toxicity, such as ulcerative cystitis, hepatic toxicity, addiction (ketamine is a drug of abuse; craving for ketamine, compulsive behavior and rapid development of tolerance is common in frequents users), psychotomimetic adverse effects such as hallucinations, disorganized thought and paranoia as well as for its potential for cognitive adverse effects. At present, there are no published studies reporting on the efficacy/effectiveness of combining multiple IV ketamine infusion followed by multiple oral ketamine in cascading dosage in patients with chronic non-cancer pain or CRPS.
Authors' methods:
A comprehensive and systematic literature search, on commercial medical literature databases by employing combination of keywords, was conducted on May 29, 2025. No limitation, such as on the language or date of publication, was implemented in any of these searches. A manual search was also conducted on the references of the articles that were retrieved in full as well as on the article collection on ketamine that the Evidence-Based Practice Group possesses from the results of our previous systematic reviews on IV ketamine, our literature surveillance on ketamine as a treatment modality for chronic non-cancer pain as well as from our previous systematic review and surveillance on treatment of CRPS.
Details
Project Status:
Completed
URL for project:
https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews
Year Published:
2025
English language abstract:
An English language summary is available
Publication Type:
Mini HTA
Country:
Canada
MeSH Terms
- Chronic Pain
- Pain
- Pain Management
- Ketamine
- Injections, Intravenous
- Administration, Oral
Keywords
- intravenous ketamine
- ketamine infusion
- oral ketamine
- pain management
- chronic non-cancer pain
Contact
Organisation Name:
WorkSafeBC
Contact Address:
6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698
Contact Name:
ebpg@worksafebc.com
Contact Email:
ebpg@worksafebc.com
Copyright:
WorkSafe BC
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.