Ketamine is not FDA Approved for the treatment of Headache

Migraine, Cluster and Stress Headache with or without Depression, can be treated (off label) with Ketamine

292. Neurology. 2013 Feb 12;80(7):642-7. doi: 10.1212/WNL.0b013e3182824e66. Epub 2013
Jan 30.

A randomized controlled trial of intranasal ketamine in migraine with prolonged
aura.

Afridi SK(1), Giffin NJ, Kaube H, Goadsby PJ.

Author information:
(1)Headache Group, Department of Neurology, University of California, San
Francisco, USA.

OBJECTIVE: The aim of our study was to test the hypothesis that ketamine would
affect aura in a randomized controlled double-blind trial, and thus to provide
direct evidence for the role of glutamatergic transmission in human aura.
METHODS: We performed a double-blinded, randomized parallel-group controlled
study investigating the effect of 25 mg intranasal ketamine on migraine with
prolonged aura in 30 migraineurs using 2 mg intranasal midazolam as an active
control. Each subject recorded data from 3 episodes of migraine.
RESULTS: Eighteen subjects completed the study. Ketamine reduced the severity (p
= 0.032) but not duration of aura in this group, whereas midazolam had no effect.
CONCLUSIONS: These data provide translational evidence for the potential
importance of glutamatergic mechanisms in migraine aura and offer a pharmacologic
parallel between animal experimental work on cortical spreading depression and
the clinical problem.
CLASSIFICATION OF EVIDENCE: This study provides class III evidence that
intranasal ketamine is effective in reducing aura severity in patients with
migraine with prolonged aura.

PMID: 23365053 [PubMed - indexed for MEDLINE]