Intravenous Infusion Therapy
Intravenous (IV) infusion therapy is a treatment option for a variety of different pain syndromes including such conditions as fibromyalgia, neuropathic pain, phantom limb pain, post-herpetic neuralgia, complex regional pain syndromes (CRPS), diabetic neuropathy, and central pain related to stroke or spinal cord injuries. The medication infusions can also be used in special occasions for the treatment of severe depression and refractory headaches.
Pain Medicine Consultants offers the most innovative medication infusion program in the country. Our Neuraxxis neurogensis infusion program is designed to help relieve chronic pain, anxiety, depression, and severe stress related symptoms. Please schedule a consultation to see if you are a good candidate and to find out more information.
A variety of different medications can be used for infusion therapy:
- B Vitamins
One or more of the indicated medications are typically mixed into a saline infusion bag and slowly infused into a peripheral vein.
Your physician will select the appropriate medication and dose to be used in the infusion depending on your diagnosis and the type of pain you are experiencing. An intravenous catheter will be placed in your arm or hand and then the medications will be infused over a standardized amount of time. You will be monitored throughout the infusion period.
IV Infusion Medications
Lidocaine blocks the sodium channels in the neuronal cell membrane that may potentially play a role in the pathogenesis and maintenance of both neuropathic and inflammatory pain.
Ketamine is an N-methyl-D-aspartate (NMDA) Receptor antagonist that decreases sustained neuronal depolarization as well as excitatory transmission along afferent pain pathways in the dorsal horn of the spinal cord.
Clonidine is an α2-adrenergic receptor agonist that is believed to reduce of norepinephrine release from the α2-adrenergic in the peripheral nervous system.
Magnesium works as a competitive NMDA receptor antagonist that decreases both acute and chronic pain by stabilizing abnormal nerve excitation.
IV Infusions were first introduced as a treatment for pain in 1963 using lidocaine. Since then several studies using different medications have shown benefit in treating patients with chronic pain. The goal of therapy is to substantially decrease your level of pain and make you more functional over the long term.
As with any medical procedure, there is always a risk of potential complications. The most common complaints one might experience with infusion therapy are associated with the medication being used. In most cases, the symptoms or side effects will abate once the infusion is completed or stopped.
There are a number of scientific studies and clinical impressions supporting the use of IV infusions for the treatment of variety of different types of pain.
Frequently Asked Questions - Intravenous Infusion Therapy
Pain Medicine Consultants offers the most innovative medication infusion program in the country.
Our Neuraxxis neurogenesis infusion program is designed to help relieve chronic pain, anxiety, depression, and severe stress related symptoms. Please schedule a consultation to see if you are a good candidate and to find out more information
What is an infusion?
It is a very simple procedure, an IV will be started in your arm or leg and a bag of normal saline mixed with the medication will be slowly given to you.
What conditions can you treat?
Persons with neuropathic pain that is not well controlled with injections, nerve blocks, or prescription pain medication. Examples of this kind of pain are trigeminal neuralgia, complex regional pain syndrome (CRPS/RSD), phantom limb pain, diabetic and other neuropathies, post-herpetic neuralgia, and some headaches.
- Persons with chronic back and neck pain no longer responsive to any form of treatment.
- Persons with debilitating fibromyalgia.
- Persons with severe depression.
Is Infusion Therapy Right for me?
If you suffer from chronic pain that has not responded to medication or other traditional treatment modalities, then infusion therapy may be an option for you. The procedure is easy to administer and essentially pain free. There will be an initial evaluation with your doctor to see if infusion therapy is right for you
What is ketamine?
Ketamine is an FDA approved anesthetic drug that has been used in hospitals worldwide since the 1960’s. In the last few years numerous articles in medical journals have shown efficacy in using ketamine in sub-anesthetic doses to treat depression and some chronic pain syndromes.
Ketamine's anesthetic effects are mediated by interactions with a member of the glutamate receptor family, the NMDA receptor. It interacts with other receptors as well, including opioid receptors, dopamine receptors; and a receptor known as the AMPA receptor, thought to be an important component of its antidepressant effects.
How long is the infusion?
Depends on your diagnosis and protocol, most of the infusions will be 1 hr. After the infusion you will stay for another 30 minutes to recover. If you have CRPS/RSD your infusion will be longer 3-4 hours usually
Will I be awake?
Yes, the dose that we use will not put you to sleep.
What to expect during the infusion?
Some possible side-effects include dizziness, blurred vision, nausea, and hallucinations, these are rare and dose related, they can be treated immediately to make your experience as pleasant as possible. Within 15 minutes of ending the infusion your mind will be clear. There are no delayed “flashbacks.”
How many infusions will I need?
The response to treatment varies. Most patients require several treatments and the amount of medication and the number of infusions required depends on both the medication and the protocol being used. Some people respond immediately, but most will not feel the true benefit until several treatments have been administered.
Will I get better?
It is possible to undergo ketamine infusion therapy and have no beneficial effect. Patients must make their own decision to voluntarily proceed knowing it may have no beneficial effect. However the data from many practitioners show that up to 70% of the patients will have significant improvement of their symptoms.
Can I get addicted?
Because it is used as a “party drug” there is a legitimate worry about addiction potential. Studies and clinical experience have found that in the very low doses used, medical setting, lack of access at home, and infrequent dosing, there is virtually no potential for addiction or abuse.
Do I need a referral?
Yes, we require a note from your treating provider, you will need to fill the initial form and will be seen for an initial consultation, all your documents/labs will be reviewed and we will determine if you are a candidate for IV infusions. If you are a Pain Medicine Consultants patient you don’t need a referral.
Do I need to stop my medications?
We recommend that you don’t take Benzodiazepines such as Xanax, Ativan, Valium, or Klonopin, and amphetamine-based stimulants, such as Adderall or Ritalin the day of treatment.
What medical conditions will exclude me from ketamine treatment?
Any medical condition that is not well managed would preclude you from treatment. Uncontrolled high blood pressure, or any serious cardiac or respiratory conditions need to be disclosed to avoid complications.
Do I need someone with me?
You will need a responsible adult to take you home after your infusion you will not be able to drive for 12 hours after the infusion.
Can I eat before the infusion?
We require that you don’t eat any solid food 8 hours before your infusion, you are allowed to have clear liquids such as water, clear broth, apple juice or clear tea/coffee (no milk or leaves) up to 2 hours prior to your appointment.
Will my insurance cover or reimburse me?
We do not participate in any insurance plans and will not bill them on your behalf. We can provide you the necessary forms for you to submit to your insurance company after treatment for reimbursement to the extent that they will cover this service. We can’t guarantee that your insurance will reimburse you the total or partial amount.
References - Intravenous Infusion Therapy
- Systemic Administration of Local Anesthetics to Relieve Neuropathic Pain: A Systematic Review and Meta-Analysis
- Intravenous regional anesthesia with clonidine in the management of complex regional pain syndrome of the knee
- Intravenous Magnesium for Chronic Complex Regional Pain Syndrome Type 1 (CRPS-1)
- Magnesium for Headaches
- Outpatient Ketamine Double-Blind Placebo Controlled Study
- RSD Foundation - The Safety Side of Ketamine
- RSDHope - Debilitation Pain Syndrome
- International Research Foundation - Ketamine Infusions
- Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial
- Ketamine as a Novel Antidepressant: From Synapse to Behavior
- Serial infusions of low-dose ketamine for major depression
- Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment Resistant Major Depression
- Signaling Pathways Underlying the Rapid Antidepressant Actions of Ketamine
Replication of Ketamine's Antidepressant Efficacy in Bipolar Depression: A Randomized Controlled Add-On Trial
- Antidepressant effects of ketamine: mechanisms underlying fast-acting novel antidepressants
- Ketamine May Give ‘Almost Instantaneous’ Relief for Severe Depression
- Yale Scientists Explain how Ketamine Vanquishes Depression within Hours
- CBS - Ketamine May be Quick-Effective Treatment for Untreatable Depression