Migraine Treatment

IV ketamine for migraine is used off-label — ketamine is FDA-approved as an anesthetic and for treatment-resistant depression via the intranasal esketamine formulation, but not specifically for migraine. Its off-label use for refractory and chronic migraine is supported by published case series, systematic reviews, and real-world clinical data, and it is increasingly recognized by headache specialists as a viable option for patients who have exhausted standard treatments. At Revitalized Clinic, we walk you through the evidence honestly at your consultation.

Research suggests that IV ketamine can produce acute pain relief in migraine patients within 44 minutes of infusion on average, according to the systematic review cited in Practical Neurology (2024). This rapid onset distinguishes ketamine from all preventive migraine medications, which require weeks to months to show any effect, and from many acute treatments that work only during a narrow window at the start of an attack.

Status migrainosus is a migraine attack that lasts longer than 72 hours and has not responded to standard acute treatment. It is one of the most debilitating migraine presentations and represents a clinical emergency for many patients. IV ketamine has documented use in both inpatient and outpatient management of status migrainosus, and is discussed in headache medicine literature as an alternative to the Raskin protocol (IV dihydroergotamine) for refractory cases. Our clinical team will assess your eligibility for treatment promptly if you present with status migrainosus.

Medication overuse headache — also called rebound headache — develops when acute migraine medications are used too frequently, causing the brain to become increasingly sensitized to pain. Because ketamine is opioid-sparing and works through a separate receptor mechanism, research suggests it may offer benefit in patients whose standard migraine medications have lost efficacy through overuse, according to The Journal of Headache and Pain case series.

IV ketamine infusions for migraine are currently self-pay at Revitalized Clinic. We encourage patients to contact their insurer about possible reimbursement through a superbill. Our team is glad to discuss all payment options at your free consultation.

This depends significantly on your migraine pattern, severity, and individual treatment response. Some patients experience meaningful reduction in migraine frequency and severity following a single infusion. Others benefit most from a structured induction series with maintenance infusions at intervals determined by their documented response. Real-world data suggests that roughly two thirds of responders will need a booster at three to six months. Our team will give you an individualized estimate based on your specific clinical presentation.