Can Ketamine Help MS Patients? What the Research Is Starting to Show!

by Denise Love

What is Multiple Sclerosis?

Multiple sclerosis (MS) is a complex neurological condition that has no cure. For people diagnosed with this disease, their own body attacks the myelin sheath of nerve cells, disrupting communication to areas of the body and leading to symptoms such as muscle weakness, uncoordinated walking, and visual and cognitive disturbances, among others. People with MS often also experience overwhelming fatigue and depression that is treatment-resistant to current pharmacological therapies.  

Recently, I had a patient ask me for advice about Ketamine for her MS fatigue, whether I thought it was safe, and whether it would work.  As this type of treatment is not part of my current practice, I did not have a confident answer for her.    I was aware that there are Ketamine clinics around the country that are using this off-label for a variety of conditions, but I knew little about it. Her specific question led me to research the emerging science of Ketamine for the symptoms associated with the condition of MS.  

Why Ketamine?

Ketamine has gained attention in the medical community over recent years for its rapid effects on the treatment of depression, fatigue, and chronic pain symptoms, beyond its current FDA-approved listing as an anesthetic for surgical and medical procedures. Ketamine works by targeting the N-methyl-D-aspartate (NMDA) receptor, which is the brain's primary excitatory neurotransmitter, promoting neuroplasticity. Researchers are highly interested in this drug specifically for the treatment of depression and fatigue in MS patients, as traditional treatments such as antidepressants and stimulants do not seem to have the same effect in persons with MS suffering from fatigue and mood symptoms as they do in the general population.   While there is no cure for MS, researchers are hopeful that there will be some neuroprotective effects from this drug that will either slow or halt the progression of the disease.  

What Are Early Research Findings Telling Us?

In 2021, researchers conducted a small pilot study for the treatment of MS-related fatigue that included depression scores.  They found that there was no change in depression scores after one week,  but further analysis did show some reduction of longer-term fatigue in patients with MS. Their findings suggested that additional research is needed.  

In 2004, researchers conducting animal studies on mice found positive results that may apply to humans, potentially improving pathological changes in the spinal cord and offering some protection for brain tissue. Researchers hypothesize that this discovery could lead to a prophylactic drug in MS treatment in the future.

A larger 30-month study involving 100 patients is currently being conducted at the Johns Hopkins MS Center to investigate the effects of Ketamine on fatigue in MS patients.  Results from this study will not be available until sometime after March 2026.

What we know so far is that the early results are promising, but more research and data are needed.  

What MS Patients Are Saying?

In a single case report published in 2017, researchers studied a patient over a two-year period. During that time, she had received Ketamine for treatment-resistant depression. Researchers found she was able to maintain a non-depressed mood during this time and had no worsening symptoms of her MS.      

Anecdotal reports on social media platforms like reddit, where some patients report having tried Ketamine and report positive results. These types of reports in public forums do help explain the rising interest in this treatment option.  

A word of caution is noteworthy here, as individual experiences vary, and any reports shared through social media platforms should not be considered clinical proof.    

What are the Risks and Limitations?

If you are interested in this treatment, it is essential to be aware of the potential risks and side effects associated with it. You should only receive this medication in a reputable clinic with a qualified physician and nursing staff trained in advanced life support in case something goes wrong. Potential side effects include, but are not limited to, dissociation, increased heart rate, elevated blood pressure, dizziness, and short-term confusion. It is not suitable for everyone.

Because this drug is still in the research phase for the treatment of MS symptoms, optimal dosing, its effect on MS progression, and safety data are not well established yet. And because it is not yet FDA-approved for this application, most people will find it to be an out-of-pocket expense that many will be unable to afford.  

Ketamine: A New Option Worth Watching.

So, in conclusion, should my patient get Ketamine for her MS fatigue? Perhaps. Anyone considering this type of treatment should conduct their own research, seek out reputable doctors who offer this service, and thoroughly understand the associated risks and benefits. The research suggests that Ketamine treatments may provide meaningful symptom relief for some MS patients. Still, caution should be taken, as ongoing clinical trials will help clarify who benefits most and how to use it safely. As MS care continues to evolve, Ketamine could be one of the tools reshaping how we manage difficult-to-treat symptoms.

References

Fitzgerald, K. C., Morris, B., Soroosh, A., Balshi, A., Maher, D., Kaplin, A., & Nourbakhsh, B. (2021). Pilot randomized active-placebo-controlled trial of low-dose Ketamine for the treatment of multiple sclerosis-related fatigue. Multiple sclerosis (Houndmills, Basingstoke, England), 27(6), 942–953. https://doi.org/10.1177/1352458520936226

Ghajarzadeh, M., Roman, S., Vega, L., & Nourbakhsh, B. (2023). Low-dose ketamine infusion for the treatment of multiple sclerosis fatigue (INKLING-MS): Study protocol for a randomized, double-blind, active placebo-controlled phase II trial. Contemporary clinical trials, 126, 107106. https://doi.org/10.1016/j.cct.2023.107106

Jelen, L. A., Young, A. H., & Stone, J. M. (2021). Ketamine: A tale of two enantiomers. Journal of psychopharmacology (Oxford, England), 35(2), 109–123. https://doi.org/10.1177/0269881120959644

Messer, M. M., & Haller, I. V. (2017). Ketamine Therapy for Treatment-resistant Depression in a Patient with Multiple Sclerosis: A Case Report. Innovations in clinical neuroscience, 14(1-2), 56–59.

National Institute of Neurological Disorders and Stroke. (n.d.). Multiple sclerosis. U.S. Department of Health and Human Services, National Institutes of Health. https://www.ninds.nih.gov/health-information/disorders/multiple-sclerosis

Wang, X., Yang, J., & Hashimoto, K. (2022). (R)-Ketamine as prophylactic and therapeutic drug for neurological disorders: Beyond depression. Neuroscience and biobehavioral reviews, 139, 104762. https://doi.org/10.1016/j.neubiorev.2022.104762

Assessed and Endorsed by the MedReport Medical Review Board