Beyond the Raskin Protocol: Ketamine, Lidocaine, and Other Therapies for Refractory Chronic  Migraine

AbstractPurpose of ReviewThe purpose of this review is to discuss the available evidence and therapeutic considerations for intravenous drug therapy for refractory chronic migraine.Recent FindingsIn carefully monitored settings, the inpatient administration of intravenous lidocaine and ketamine can be successful in treating refractory chronic migraine.SummaryMany patients with refractory chronic migraine have experienced treatment failure with the Raskin protocol. The use of aggressive inpatient infusion therapy consisting of intravenous lidocaine or ketamine, along with other adjunctive medications, has become increasingly common for these patients when all other treatments have failed. There is a clear need for prospective studies in this population comprised of patients who have largely been excluded from other studies.
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research