More than one billion people—or one in seven—get migraines each year. Females are affected more than males. These extremely painful headaches are debilitating and accompanied by stress, nausea, sleeplessness, and even suicide. It’s no surprise that migraines are the second leading cause of disability and a common reason for emergency room visits. Today, we are going discuss the causes of migraines, including risk factors and triggers, symptoms, and treatments including IV ketamine therapy.
Like the large number of risk factors believed to cause migraines, there are numerous treatments. Treatments include over the counter (OTC) drugs, prescription medications, and at-home remedies. Many treatments, like Non-Steroidal Anti-Inflammatory Drugs or NSAIDs target pain relief after a migraine has started. Others are preventative by reducing the frequency or severity of a headache before it grows into a migraine. Some like Nurtec claim to do both.
Common household medicines containing aspirin, ibuprofen (Motrin, Advil), acetaminophen (Tylenol), and naproxen (Aleve) are popular because they’re accessible. By prescription, medicines include triptans such as sumatriptan (Imitrex) and rizatriptan (Maxalt). There are also anti-hypertensives such as propranolol, antidepressants such as amitriptyline, anti-epileptics such as topiramate, Botox injections, and monoclonal antibodies. Treatments may come in the form of supplements, injections, nasal sprays (zavegepant), and special fitting bracelets and headwear.
Despite these several options, some are still looking for a treatment which works for them.
According to Yale Medicine, “A migraine is a neurologic disorder that causes moderate-to-severe headaches along with other symptoms that make it difficult for people to function normally.”
There are many. They include nausea, fatigue, increased light and sound sensitivity, and moderate to severe pain. Further these severe headaches may be episodic and throbbing or steady pain. Pain may be felt on both sides of the head or isolated and can last for hours to days. Clearly, migraines interfere with daily activities including work and relationships.
Some migraineurs experience signs prior to the onset of pain that may be described in phases:
Age and Sex: Women are three times more likely to suffer from migraines than men, and although they usually start during adolescence, migraines usually peak during the third decade of life.
Genetics: Migraines may be hereditary. People suffering from migraines have approximately a 75% chance of having a first-degree relative also with a history of migraines.
Hormones: It’s common for women to experience migraines during the menstrual period of their cycle. Fluctuations with hormones including estrogen are thought to play a role with the onset of migraine symptoms. Research is lacking on the role hormones play in migraines in men.
Several things may initiate a migraine such as emotional stress, sleep (too much or too little), caffeine, alcohol, dehydration, diet (artificial sweeteners, MSG, chocolate), weather changes including extreme heat or cold, and light (flickering and or bright lights).
For some people, IV ketamine is an effective and fast-acting option for migraine relief.
By targeting NMDA-type glutamate receptors throughout the central nervous system and peripheral tissues, IV ketamine may reduce migraine likelihood and severity. Because these receptors are believed to mediate the sensation of pain, by blocking the NMDA receptor, ketamine (and some of its key metabolites) may prevent hypersensitivity to external stimuli which trigger and exacerbate migraines. The sensation of pain is blunted or blocked which can occur within minutes after receiving an IV ketamine infusion.
Past studies have shown that IV ketamine can be a safe and effective treatment for refractory chronic migraines by reducing the severity and/or duration of the aura. One observational pilot study showed that one of ketamine’s key metabolites may alleviate short-term pain associated with migraines. And in another study with chronic migraines, all patients achieved a target pain level of 3 or less after IV ketamine infusions.
Research published in the Journal of Headache and Pain showed promise, “Our IV ketamine infusion protocol, based on gradual dose escalation, relieves pain without substantial adverse effects.” In another study done by the American Society of Anesthesiologists, 75% of the 61 people involved in the study reported an improvement in their migraine pain after receiving a ketamine infusion.
Lastly, we agree with the authors of this meta-analysis which looked at the efficacy of ketamine in treating migraines. The scientific study of ketamine and its ability to alleviate migraine symptoms must be continued and expanded.
Migraines are common and can cause a significant burden to those suffering from this chronic neurological illness. Today, we defined what migraines are, common symptoms, risk factors and triggers, and lastly discussed treatment options.
At Innerbloom Ketamine Therapy, we often see patients who have tried multiple treatment modalities for pain and migraines who unfortunately have not had much relief or any at all.
According to Dr. Duren Michael Ready, headache specialist at Baylor Scott & White Health in Temple, Texas, “Ketamine might be useful for someone not getting better with typical treatments. These might be patients whose headaches have progressed. Their nervous system is so totally sensitized to where almost any input is going to bring about pain. For these individuals, oral medications like triptans or the nonsteroidals aren't going to be very effective."
IV ketamine therapy has been shown to reduce severity of migraines and is a safe and effective option for those who seek other options for treatment. Additionally, IV ketamine has been proven to improve depression and address other pain conditions which allows for improved quality of life.
About the Author
Dr. Ray Rivas, a former general and trauma surgeon with over a decade of experience utilizing ketamine, became a ketamine therapy specialist to treat mental health and pain after witnessing its profound impact on his hospital trauma patients and his own mental health. As the founder and medical director of Innerbloom Ketamine Therapy in San Luis Obispo, California, Dr. Rivas applies his extensive medical expertise to provide safe, evidence-based ketamine treatments for mood disorders, including depression, anxiety, PTSD, and chronic pain. His passion lies in helping patients find relief and rediscover hope through personalized, compassionate care.
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