Brief Answer:
It is recognized but not common

Detailed Answer:
Good afternoon sir. I am a neurologist practicing in the XXXXXXX Ohio area.

So it sounds as if you get significantly increased tone in your muscles from shoulders to fingertips. Now, does that mean the ENTIRE length and circumference of the UPPER EXTREMITIES? And then, you say from hips to toes so again, the entire length of the LOWER EXTREMITIES? And you become stiff as a board. Do all muscle groups go stiff at once? Or is it a progression of some sort? And how long does all this last? And what is your level of consciousness like during the entire time? Awake, alert, aware of what's going on, or are you confused, lethargic, and somewhat out of it? Is there pain when this happens or just tightness?

How long after the infusion of ketamine does this happen since most infusion protocols are several hours in length I would wonder if these symptoms don't appear during the infusions themselves? If so, doe the nurse notice what's going on? Do you report to her and what her response? Do these spasms happen every time following infusion and then, subside until after the next infusion?

So in the literature there is reference to tonic/clonic activity resembling seizures in the musculoskeletal system following ketamine infusions. Incidence and risk of this side effect is not known so I would consider it a rare to isolated event. In fact, the nice thing about ketamine is that if one starts experiencing side effects during the infusion then, it's easy to fix. You either back off of the infusion rate or the dose and you should see nearly immediate relief. However, as far as a side effect that might occur away from the infusion itself that might have more to do with just how much modulation is occurring in your peripheral or central nervous systems (i.e. the reason you're getting the infusion in the first place) which could be dependent upon the total dose you are receiving.

How often are you going for these infusions? There are different protocols of several times per month to as many as 10 days per month and then, there are those who only have to go once every 2-3 months once they come under good control. Another thing that can be tried to avoid the spasms or "seizure" like events if that's what's happening would be the concomitant infusion of an agent along with the ketamine. I've had patients for which these infusions go much better when they are essentially put out with a little dose of midazolam or similar. They then, have much less cramping or muscle stiffening such as what you're talking about. You should talk to your infusion doctor about these issues though because chances are they are not aware of your problems....especially if they're not happening at the infusion center itself.

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This query required 46 minutes of physician directed time for review, research, and final draft documentation for envoy.

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