Standard treatment for migraines normally relies on ibuprofen, lying in a dark room, and waiting for the nausea to pass. But now patients could potentially be given a dose of ketamine after a 75% success rate in experimental trials.
The powerful anaesthetic is commonly used for pain relief during surgery and treating depression, but a team in the USA has been testing lower doses as a way to stop the debilitating headaches.
And it could be most powerful for patients who have not been helped by other treatments.
According to the NHS, migraines affect 20% of women in the UK and 1 in every 15 men. Beginning in early adulthood, most people only have a migraine occasionally but for others they can occur up to several times a week.
With symptoms including a moderate or severe headache, felt as a throbbing pain on one side of the head, nausea, vomiting and increased sensitivity to light or sound, migraines can make attending work difficult.
As a result it is crucial to find a treatment for those who have failed to have success with conventional solutions.
The study, presented at the Anesthesiology 2017 annual meeting, took 61 patients who have so far failed to find an effective course of treatment for their migraines and placed them at an inpatient infusion centre for a three to seven day course.
On a scale of 0-10, the average migraine headache pain rating at admission was 7.5, compared with 3.4 on discharge.
The average length of infusion was 5.1 days, and the day of lowest pain ratings was day 4. And adverse side effects were generally mild.
Eric Schwenk, director of orthopedic anesthesia at Thomas Jefferson University hospital, said: “Our study focused only on short-term relief, but it is encouraging that this treatment might have the potential to help patients long-term.”
Schwenk said he could not categorically say that the ketamine was “entirely responsible” for the pain relief, but the initial results were promising.
The treatment is not widely available at the moment, but the hospital is opening a new infusion centre later this year, Schwenk said: “Our work provides the basis for future, prospective studies that involve larger numbers of patients.”
The exact cause of migraines is unknown, although they’re thought to be the result of temporary changes in the chemicals, nerves and blood vessels in the brain.
Around half of all people who experience migraines also have a close relative with the condition, suggesting that genes may play a role.