So today I want to share with you about ketamine's role in treating fibromyalgia.
Fibromyalgia is a very painful condition affecting up to 10 million Americans. Now
what's the cause of fibromyalgia and one of the main hypotheses is something
called central sensitization. Central sensitization refers to a process where
the central nervous system actually gets into a wind-up state. Meaning that it's
at a state where its persistently stimulated at a higher level than what would be in
a normal central nervous system. A person with fibromyalgia might get very mild to
moderate touch but that would cause an exquisite amount of pain because the
pain receptors have become hyper sensitized. The NMDA receptor plays a
role in this whole central sensitization process. Now here's the coolest part
ketamine is the most potent clinically available NMDA receptor blocker and so
this is the mechanism of how ketamine can work in treating fibromyalgia. The
other area that fibromyalgia seems to impact is the default mode network.
The default mode network is a certain portion of the brain that becomes active
when we're supposed to be daydreaming or just basically doing nothing. And it's
supposed to link the cerebral cortex with the limbic system and as well as
the reptilian system of the brain. And so the default mode network is kind of like
a grand central train station that is kind of orchestrating activity from
below ie the more basic functions of the human brain and the cerebral cortex more
of the evolutionarily advanced portions of the brain. The default mode network
has been implicated in playing a significant role in depression, chronic
pain, like fibromyalgia. Ketamine has been shown to reduce activity of the default
mode network. And so it could be possible that fibromyalgia and the fact that the
default mode network is altered in patients with fibromyalgia is where
ketamine seems to be helping patients in this particular area. One last area
is something called small fiber neuropathy. Small fiber neuropathy is
actually a separate clinical diagnosis but what they found in patients with
fibromyalgia, once they did muscle biopsies, they also found that patients
at small fiber neuropathy. So what causes small fiber neuropathy no one really
knows but it's hypothesized that it could be related to inflammation that's
occurring. Ketamine has been shown to reduce levels of tumor necrosis
factor-alpha. TNF alpha now this factor is a very
potent immuno stimulator and what ketamine does is it reduces that
activity of inflammation via reducing activity of TNF alpha. So could it be
possible that fibromyalgia has a component of inflammation that's
actually making it worse and maybe that's also the reason why ketamine can
play a role in treating patients with fibromyalgia or even other autoimmune
disease like rheumatoid arthritis or lupus or Sjogren's. These are all
possible mechanisms and potentials that ketamine can influence and might be
able to treat. Now there are not a lot of studies using ketamine in autoimmune
disorders and so there's limited data from that perspective but it's still an
interesting question how ketamine can reduce the inflammation in the human
body and that inflammation might actually be playing a significant role
in fibromyalgia. Now what if there's another component beyond the biological
psychological brain component of fibromyalgia. What if there's actually a
spiritual component to all of this. As a physician we can't really talk about
spiritual diseases but as a human being this is something to consider.
Maybe fibromyalgia has a spiritual component.
What if ketamine is actually helping people with the psycho social spiritual
component of fibromyalgia and that's when we started thinking about these
experiential effects that ketamine can create. The spiritual or mystical effects
that a patient can have. Because we've had patients who feel like
they reached a connection with God or the source. We've had patients who have
had complete blocking of their thoughts and where they were just in the human
being without that mental chatter that's always on. Maybe ketamine is playing a
role in this psychosocial spiritual aspect that can't be quite fully
monitored numerically. Fibromyalgia is challenging because there's not a lot of
good options for it. I mean you have anti-inflammatories, sometimes some
opioids, and other times some antidepressants such as duloxetine. So
those are some options but even after that some patients still have a lot of
pain with fibromyalgia and this is where ketamine infusions come in. So if you
know anyone out there with fibromyalgia who's not getting fully treated or who's
still in quite a bit of pain and fatigue have them watch this video. Learn a
little bit more about another option that's potentially available to them. If
you have any questions or comments please leave them below.