Ketamine for Lyme Disease Pain Relief: Could It Help?
Pain may persist after Lyme disease treatment
Ketamine reduced pain in one PTLDS case report
More studies are needed before broader use
Chronic pain after Lyme disease can be difficult to manage, especially when symptoms persist despite multiple therapies. Researchers described a woman with post-treatment Lyme disease syndrome (PTLDS) whose severe pain improved substantially after treatment with intravenous ketamine.
Post-treatment Lyme disease syndrome (PTLDS) refers to persistent symptoms that continue after standard treatment for Lyme disease.
Many patients search for Lyme disease pain relief after standard treatments fail to control burning pain, neuropathy, fatigue, and widespread discomfort.
Why ketamine was considered for Lyme disease pain
One published case explored whether ketamine might help when multiple conventional therapies failed.
In the International Medical Case Reports Journal, researchers described a 31-year-old woman with PTLDS whose pain persisted despite multiple therapies, including procedures, medications, and supportive treatments. [2]
Her symptoms began gradually approximately 3 years earlier after Lyme disease diagnosis and treatment. The patient reported diffuse body pain, fatigue, headaches, and significant cognitive symptoms often described as brain fog. [2]
Patients with persistent pain after treatment may also experience symptoms involving brain fog, fatigue, and broader manifestations of persistent Lyme disease symptoms.
Case report: PTLDS patient with refractory pain
The woman’s pain worsened despite treatment and interfered with routine activities.
Her treatment history included opioid medications, psychiatric medications, physical therapy, intravenous vitamin infusions, trigger point injections, and radiofrequency ablation, none of which produced meaningful improvement. [2]
Persistent pain after Lyme disease may overlap with neuropathy, burning sensations, numbness, or other neurologic symptoms.
Persistent pain remains one of the more difficult complications addressed in patients with post-treatment Lyme disease syndrome.
Could inflammation contribute to persistent pain?
The authors proposed that the woman’s symptoms could involve immune dysfunction triggered by infection. Ketamine has anesthetic, anti-inflammatory, and immunomodulatory properties that could potentially influence these pathways. [2]
Ketamine has also been explored in several chronic pain conditions where conventional therapies have provided limited benefit.
The patient received ketamine as an off-label treatment for refractory pain. According to the authors, ketamine has previously been explored for neuropathic pain conditions that lack consistently effective treatments. [2]
Ketamine as a Lyme disease pain treatment option
Ketamine treatment reduced the woman’s pain by approximately 71%.
Importantly, improvement occurred without increasing opioid use. The patient reportedly reduced fentanyl dosing substantially while maintaining improved symptom control. [2]
The authors also noted improvement in depression symptoms following treatment. [2]
These findings raise the possibility that opioid-sparing therapies deserve additional study for patients with persistent Lyme-related pain.
This report describes only one patient. Larger studies are needed before determining how effective ketamine may be for broader groups of patients with persistent Lyme-related pain.
Ketamine treatment requires medical supervision and may not be appropriate for every patient.
Frequently Asked Questions
Can ketamine help Lyme disease pain?
This case report suggests ketamine may reduce pain in some patients with persistent Lyme-related symptoms, but larger studies are needed.
Can ketamine reduce opioid use in Lyme disease patients?
In this case, ketamine treatment was associated with lower opioid requirements while maintaining improved pain control.
Is ketamine approved for PTLDS?
No. Ketamine was used off-label in this case report.
Clinical Takeaway
A single case report found significant improvement in severe Lyme-related pain following ketamine treatment.
Questions remain regarding whether inflammation, immune dysfunction, persistent infection, coinfections, neurologic dysfunction, or overlapping mechanisms contribute to persistent symptoms in these patients.
More research is needed to determine which patients may benefit and whether ketamine has a broader role in managing persistent Lyme-related pain.
Related Articles
The risk of pain and fatigue after three weeks of Lyme disease treatment
Women with chronic Lyme disease may suffer from a severe immune response triggered by the disease
Chronic Lyme disease pain: understanding persistent symptoms
Post-treatment Lyme disease syndrome overview
References
- Bechtold KT, Rebman AW, Crowder LA, Johnson-Greene D, Aucott JN. Standardized Symptom Measurement of Individuals with Early Lyme Disease Over Time. Arch Clin Neuropsychol. 2017;32(2):129-141.
- Hanna AF, Abraham B, Hanna A, Smith AJ. Effects of intravenous ketamine in a patient with post-treatment Lyme disease syndrome. Int Med Case Rep J. 2017;10:305-308.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
good luck trying to get ketamine,,,,I was diagnosed with Lyme in 2005.I was on various abx for 2 1/2 years.I am still very sick and I hurt so bad and my brain is on fire.I had a 2 level back surgery 10 months ago and it sent my Lyme into overdrive…the oxycodone I take seems to only make me more susceptible to pain..it’s a joke.I would like to try the ketamine and get off the opioids.. easier said than done I think.
Hello Marc, I hope the very best for you. But I have a back surgery scheduled a few weeks away. I’ve endured on and off minor issues with Lyme disease for 4 years now. What type of surgery did you have? And are you better outside the pain?
Hi. If I read this, then I have a succesfull treatment because this I do not have, no burning and such, but tiredness and sleep is bad, I can sleep better when use magnesium and oxazepam, last drug is not suitable for longer times. So I start Ghanese kinine and see what it does. I did also read kinabast do work well.
Hi
I had lyme, did discover this because of ACA on one leg, get antibiotics after a test and biopt, I think have not completely cured so I ask here, what does a not cured Lyme?
For me I have symtomes like a kind of flu like symptoms, fatigue, nog good sleep, (do I sleep well fatigue is much less) have feelings like insects under the skin, stress feelings and massive feelings.
I do excercise, pain is very light and not present when rest and watch tv, do yoga, then I can feel that muscles are stiff and little painful. I can do make a trip with the bicycle, last I did 60 km, and yes after that I was tyred but are also 66 of age.
The ACA on the leg is still gone after now 10 months after treatment with doxy, bet have symptoms who do are not pleasant, sleep and tiredness but soemtimes I are quite good feelings. I have not nerve problems, I have the borrelia skin infecting strain.
I also did hear that symtoms after treatment can be present for some 2 years.
I am using now starting today ghanese Kinine to try out if it does help.
regards
What is ACA? I’m 20 years younger and I used to run marathons and was super athlete. Now I get sore when I do 5 squats. You sound pretty good for 66!
ACA in Lyme (Acrodermatitis Chronica Atrophicans) It is a late-stage skin manifestation of Lyme disease (more common in Europe than the U.S.).
Hey! Im the woman in that case study!
That’s incredible—thank you for sharing your story. Cases like yours help bring real awareness to how complex Lyme can be.