Ketamine Eliminated Pain in Patient with Fibromyalgia and RA, Case Study Says

Ketamine Eliminated Pain in Patient with Fibromyalgia and RA, Case Study Says
Treatment with intravenous ketamine eased pain significantly in a patient with rheumatoid arthritis (RA) and fibromyalgia, a case report shows. The report, “Intravenous Ketamine Alleviates Pain in a Rheumatoid Arthritis Patient With Comorbid Fibromyalgia,” was published in the journal The Journal of Medical Cases. Patients with RA are at increased risk to develop fibromyalgia. Both disorders disproportionally affect women. RA may be treated with diverse types of medications that target pro-inflammatory cytokines —  molecules released by immune cells — including analgesics, non-steroidal anti-inflammatories (NSAIDs), glucocorticoids, and disease-modifying therapies. However, lack of response in some patients and medication-related problems warrant evaluation of alternative treatments. Intravenous (IV) ketamine has been an FDA-approved medication for nearly 50 years. Ketamine blocks the NMDA (N-methyl-D-aspartate) receptor, which is key in neuronal communication and is involved in regulating pain signals in the brain and spinal cord. Excessive activation of this receptor may cause toxicity, leading to various pain disorders. By blocking NMDA receptors, ketamine may correct this over-activation. However, ketamine’s therapeutic effects go well beyond its levels in the body, which leads scientists to speculate that it induces secondary changes that result in durable benefits. A combination of analgesic, immunomodulatory and anti-inflammatory effects have been proposed for ketamine, which makes it promising for treating RA, according to the authors. This report describes the case of a 49-year old woman with RA whose arthritis did not respond to conventional treatment options and resulted in permanent, extreme pain. She reported joint pain with
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