Understanding Pain and Pain Treatment for Veterans: Responding to the Federal Pain Research Strategy

Bastian, Lori A.; Heapy, Alicia; Becker, William C.; Sandbrink, Friedhelm; Atkins, David C.; Kerns, Robert D.

doi:10.1093/pm/pny143

Cited by 5 publications

(1 citation statement)

References 21 publications

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“…As a group, Veterans experience higher rates of chronic pain (7) and differences in underlying pain conditions, mechanisms, and responses relative to the general population (8)(9)(10). Both mental health and chronic pain conditions are costly to the individual and to society, limiting employment and increasing reliance on existing healthcare services (11).…”

Section: Introductionmentioning

confidence: 99%

Ketamine in the effective management of chronic pain, depression, and posttraumatic stress disorder for Veterans: A meta-analysis and systematic review

Liu,

Ein,

Gervasio

et al. 2024

Front. Psychiatry

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IntroductionKetamine has emerged as a promising treatment alternative for the management of chronic pain. Despite encouraging findings in civilian populations, and favourable results from trials examining its efficacy in military populations, there is still a dearth of information pointing to optimal specifications related to ketamine administration for pain, depression, and posttraumatic stress disorder (PTSD) in military populations. This meta-analysis and systematic review synthesised available evidence on the effectiveness, tolerability, and feasibility of ketamine in the management of chronic pain and mental health conditions in military populations.MethodsThis review followed the Cochrane’s Guide for systematic reviews of interventions and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) as frameworks for data collection and synthesis.ResultsA total of 11 studies and 22 independent samples were retained for data analyses. Across samples, improvements in pain, depression, and PTSD outcomes were evident, with the use of ketamine leading to significant reductions, g = 1.76, SE = 0.19, 95% CI (1.39, 2.13), Z = 9.26, p <.001. These effect sizes were robust with moderate-to-large effects. In addition, the reductions in symptoms were observed in both active-duty and Veteran groups, and for different routes of ketamine administration, frequencies of ketamine administration, duration of ketamine treatments, dosage, study design, and allowance for concurrent treatments.DiscussionThis review provides a preliminary synthesis of available evidence which suggests that ketamine may be a potential option for the treatment of depression, PTSD, and chronic pain in military populations. The viability of ketamine as an alternative treatment may be particularly impactful for those who are treatment resistant, experience chronic symptoms, and/or have exhausted conventional treatments. More research is warranted in order verify the findings presented in this review.

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