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Advances in Translational Neuropathic Research: Example of Enantioselective Pharmacokinetic–Pharmacodynamic Modeling of Ketamine-induced Pain Relief in Complex Regional Pain Syndrome

Current Pain and Headache Reports volume 15, pages 207–214 (2011)Cite this article

Abstract

Historically, complex regional pain syndrome (CRPS) was poorly defined, which meant that scientists and clinicians faced much uncertainty in the study, diagnosis, and treatment of the syndrome. The problem could be attributed to a nonspecific diagnostic criteria, unknown pathophysiologic causes, and limited treatment options. The two forms of CRPS still are painful, debilitating disorders whose sufferers carry heavy emotional burdens. Current research has shown that CRPS I and CRPS II are distinctive processes, and the presence or absence of a partial nerve lesion distinguishes them apart. Ketamine has been the focus of various studies involving the treatment of CRPS; however, currently, there is incomplete data from evidence-based studies. The question as to why ketamine is effective in controlling the symptoms of a subset of patients with CRPS and not others remains to be answered. A possible explanation to this phenomenon is pharmacogenetic differences that may exist in different patient populations. This review summarizes important translational work recently published on the treatment of CRPS using ketamine.

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Acknowledgements

This research was supported in part by the Intramural Research Program of the National Institutes of Health, National Institute on Aging.

Disclosures

No potential conflicts of interest relevant to this article were reported.

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Affiliations

  1. Department of Anesthesiology, Cooper University Hospital, 1 Cooper Plaza, Camden, NJ, 08103, USA

    Michael Sabia, Robert A. Hirsh, Marc C. Torjman, Niti Cooper, Richard Domsky & Michael E. Goldberg

  2. Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, 401 Haddon Avenue, Education and Research Building, Suite 394, Camden, NJ, 08103, USA

    Michael Sabia, Robert A. Hirsh, Marc C. Torjman, Niti Cooper, Richard Domsky & Michael E. Goldberg

  3. National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD, 21224, USA

    Irving W. Wainer

Authors
  1. Michael Sabia
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  2. Robert A. Hirsh
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  6. Richard Domsky
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Correspondence to Michael Sabia.

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Sabia, M., Hirsh, R.A., Torjman, M.C. et al. Advances in Translational Neuropathic Research: Example of Enantioselective Pharmacokinetic–Pharmacodynamic Modeling of Ketamine-induced Pain Relief in Complex Regional Pain Syndrome. Curr Pain Headache Rep 15, 207–214 (2011). https://doi.org/10.1007/s11916-011-0185-3

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  • DOI: https://doi.org/10.1007/s11916-011-0185-3

Keywords

  • Complex regional pain syndrome
  • Hydroxylated metabolites
  • Dehydronorketamine
  • NMDA receptor
  • (R,S) Ketamine
  • (R,S) Norketamine
  • Enantioselective
  • Pharmacokinetics
  • Pharmacodynamics
  • Cytochromes
  • Neuropathic pain