Chronic Pain — what we treat
- Pain persisting for ≥3 months past the original injury or onset
- Neuropathic features (burning, shooting, electric quality)
- Central sensitization — pain spreads beyond the original site
- Sleep disruption from pain
- Mood symptoms — depression and anxiety as common comorbidities
- Functional impairment in work, exercise, or relationships
- Reduced response to standard pain medications over time
How ketamine works for chronic pain
Chronic pain conditions, especially neuropathic pain and centralized pain syndromes, involve over-activation of NMDA receptors in pain-processing pathways. This receptor up-regulation is the same biological process that ketamine — a non-competitive NMDA antagonist — directly targets. Ketamine has been used in anesthesiology and pain medicine for decades; at therapeutic outpatient doses it can reduce central sensitization and the depressive symptoms that compound chronic pain. The effect on pain is often described as a "reset" rather than a continuous analgesic — sessions interrupt the pain-amplification cycle.
The at-home protocol
At-home ketamine therapy for chronic pain typically uses a similar induction (6-8 sessions over 4-6 weeks) followed by maintenance dosing every 4-12 weeks depending on response. Patients are encouraged to maintain their existing pain regimen during the induction phase — ketamine is added, not substituted. Tracking includes pain scales and functional measures (sleep quality, activity tolerance). For patients with chronic pain and comorbid depression, both targets often improve together.
Who's a candidate
Patients with neuropathic pain (post-herpetic neuralgia, diabetic neuropathy, post-surgical neuropathic pain), centralized pain syndromes (fibromyalgia, CRPS), and chronic pain with comorbid depression or anxiety are candidates. Patients on high-dose chronic opioids require additional screening — ketamine can be safely combined but the protocol may need adjustment. Patients with active substance use disorder, uncontrolled blood pressure, or unstable cardiovascular disease are not candidates.
Ketamine therapy for Randolph (Morris County) residents
Treatment is delivered entirely via telehealth. Randolph-area patients complete an online eligibility intake, have a video consult with Dr. Soffer, and receive prescription medication via mail. Sessions take place in the patient's home with a peer supervisor present. No travel to a clinic, no in-person visits required, anywhere in Morris County.
Chronic Pain + ketamine — common questions
How is ketamine different from opioids for chronic pain?
Opioids work on mu-opioid receptors and produce direct analgesia plus euphoria — they're useful for acute pain but problematic for chronic pain because of tolerance, dependence, and the ceiling on long-term effectiveness. Ketamine works on NMDA receptors and addresses central sensitization rather than masking pain in real-time. The two can be used together when appropriate; many chronic-pain patients on opioids can reduce their opioid dose after a ketamine course.
Does ketamine work for fibromyalgia?
Fibromyalgia involves central pain sensitization, which is exactly the mechanism ketamine targets via NMDA receptor modulation. Clinical research has shown ketamine can reduce fibromyalgia pain and the depression that often accompanies it. Response varies — some patients see substantial improvement, others see partial improvement — and the protocol typically combines ketamine with the existing fibromyalgia regimen.
Will I need to stop my pain medication?
Not usually. Most pain medications (NSAIDs, neuropathic agents like gabapentin or duloxetine, and stable-dose opioids) are continued through ketamine therapy. The intake reviews the complete pain regimen. The goal is often dose reduction over time as ketamine's effect compounds, not abrupt substitution.
Chronic Pain treatment in nearby NJ cities
Important: Compounded ketamine for anxiety, depression, PTSD, and chronic pain is not FDA approved. This page is informational. Eligibility and treatment decisions are made during a physician consultation based on your complete medical history.