title: Oral ketamine for children with chronic pain: a pilot phase 1 study.
abstract: OBJECTIVE
  To assess whether oral ketamine is safe at higher dosages for sedating children and whether it may be an option for the control of chronic pain in children.
  
  
  METHODS
  A prospective study was performed on 12 children with chronic pain to identify the maximum tolerated dosage of oral ketamine. Participants were given 14 days of oral ketamine, 3 times daily, at dosages ranging from 0.25-1.5 mg/kg/dose. Participants were assessed for toxicity and for pain severity at baseline and on day 14 of treatment.
  
  
  RESULTS
  Two participants, both treated at 1.5 mg/kg/dose, experienced dose-limiting toxicities (sedation and anorexia). One participant, treated at 1 mg/kg/dose, opted to stop ketamine treatment due to new pain on treatment. Nine participants completed their course of ketamine treatment. Of these 12 children, 5 experienced improvement in their pain scores, 2 with complete resolution of pain, lasting >4 weeks off ketamine treatment.
  
  
  CONCLUSIONS
  Oral ketamine at dosages of 0.25-1 mg/kg/dose appears to be safe when given for 14 days to children with chronic pain.
authors: Departments of Pediatrics and Neurosciences, Medical University of South Carolina, Charleston, SC 29425, USA. bredlau@musc.edu
authors: Amy-Lee
authors: AL
authors: Bredlau
authors: Michael P
authors: MP
authors: McDermott
authors: Heather R
authors: HR
authors: Adams
authors: Robert H
authors: RH
authors: Dworkin
authors: Charles
authors: C
authors: Venuto
authors: Susan G
authors: SG
authors: Fisher
authors: James G
authors: JG
authors: Dolan
authors: David N
authors: DN
authors: Korones
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000700:Analgesics / Q000008:administration & dosage*; D002648:Child; D059350:Chronic Pain / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000700:Analgesics; D007649:Ketamine
references: Br J Anaesth. 1981 Aug;53(8):805-10
references: 7272143
references: Int J Pharm Compd. 2002 Jul-Aug;6(4):316-7
references: 23979309
references: Hum Exp Toxicol. 2012 Jan;31(1):51-6
references: 21803783
references: Pain. 2005 Jan;113(1-2):9-19
references: 15621359
references: Pain. 2009 Jun;143(3):223-227
references: 19359097
references: Neuropharmacology. 1987 Sep;26(9):1253-60
references: 2823161
references: Pain. 2005 Mar;114(1-2):29-36
references: 15733628
references: J Clin Anesth. 1999 Dec;11(8):663-8
references: 10680109
references: J Neurosci. 2011 Nov 30;31(48):17370-82
references: 22131399
references: Br J Cancer. 2002 Jul 29;87(3):277-80
references: 12177794
references: Clin Pharmacol Ther. 1994 Jun;55(6):649-60
references: 8004881
references: J Pain Symptom Manage. 2000 Oct;20(4):246-52
references: 11027905
references: Pediatrics. 2012 Feb;129(2):354-64
references: 22250028
references: Cancer Chemother Pharmacol. 2012 May;69(5):1117-26
references: 22205203
references: J Pharmacol Exp Ther. 1999 Sep;290(3):1250-7
references: 10454501
references: Stat Med. 1995 Jun 15;14(11):1149-61
references: 7667557
references: Pain. 2009 Dec 15;147(1-3):107-15
references: 19783371
references: Anesth Analg. 2011 Nov;113(5):1254-9
references: 21788321
references: Pain Physician. 2007 May;10(3):493-500
references: 17525784
references: Pain. 2009 Oct;145(3):304-311
references: 19604642
references: Can J Anaesth. 1996 Apr;43(4):379-83
references: 8697554
references: Drug Metab Dispos. 2002 Jul;30(7):853-8
references: 12065445
references: Ann Emerg Med. 2009 Aug;54(2):181-90
references: 18990467
references: Anesthesiology. 1999 Jun;90(6):1528-33
references: 10360847
references: Biometrics. 1990 Mar;46(1):33-48
references: 2350571
references: Pain. 2011 Dec;152(12):2729-2738
references: 22078064