Pain medicine · London
Ketamine infusion for chronic pain, by a pain-medicine consultant.
Subanaesthetic IV ketamine for refractory CRPS, neuropathic pain, phantom limb pain and selected fibromyalgia. Outpatient single-session or inpatient 4 to 5 day continuous protocol, in a monitored hospital setting - not a wellness clinic.
Why patients choose us
- 01
A pain-medicine consultant, in a monitored setting
Not a wellness clinic and not a psychiatry infusion suite. A named consultant in pain medicine, working in a hospital environment with full monitoring.
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The right protocol for your pain
Outpatient single-session or inpatient 4 to 5 day continuous infusion, chosen by indication. If ketamine is unlikely to help, we say so.
- 03
Independent, and free
We take no fees from the clinics. The recommendation is impartial and costs you nothing.
Indicative pricing
What a private ketamine infusion costs in London.
Indicative ranges across our partner units. Send the pain history and we quote firm figures across outpatient and inpatient options.
In short
Outpatient single session: £550–£950. Inpatient 4 to 5 day CRPS protocol: £5,500–£9,500.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Consultation and work-up (pain consultant, ECG, bloods, urinalysis) | £350–£650 | 60 min | 48 hours |
| Outpatient single-session infusion (0.5 mg/kg over 40 min) | £550–£950 | 3 hours total | Same visit |
| Outpatient booster (repeat single session) | £450–£850 | 3 hours total | Same visit |
| Inpatient 4 to 5 day continuous protocol (refractory CRPS) | £5,500–£9,500 | 4–5 days | On discharge |
| Adjunct midazolam or clonidine cover | Included | — | — |
| Follow-up review (2, 6, 12 weeks) | £180–£280 | 30 min | Same visit |
Prices vary by unit, by consultant, by inpatient bed cost and by how long the continuous protocol runs. We come back with a firm quote within one working day.
The journey
From referral to follow-up - what happens, in order.
One team from first message to 12-week review, including cumulative-dose tracking on repeat courses.
- 01
Before
You send us a pain history
A short, confidential form. Diagnosis, duration, prior treatments (opioids, gabapentinoids, blocks, stimulator), and any cardiovascular, urological, hepatic or psychiatric history.
- 02
Before
We come back with a recommendation
Within one working day: whether outpatient or inpatient protocol fits, or whether ketamine is unlikely to help and another treatment is a better call. Indicative price.
- 03
Before
Work-up: cardiovascular, urinary, liver
ECG and BP review, LFTs, urinalysis and a symptom check for ketamine cystitis. Psychiatric screen to exclude active psychosis or unmanaged bipolar.
- 04
On the day
Arrival at the unit
Consent, IV access, baseline observations and a briefing on dissociation. Midazolam or clonidine on hand as an adjunct if perceptual effects are difficult.
- 05
On the day
The infusion itself
Outpatient: 0.5 mg/kg subanaesthetic ketamine over 40 minutes. Inpatient: 0.35 mg/kg/h continuous, roughly 100 mg per day, over 4 to 5 days for refractory CRPS.
- 06
On the day
Recovery and discharge
Outpatient: two hour recovery, home with an escort, no driving for 24 hours. Inpatient: ward stay with continuous monitoring for the duration of the course.
- 07
After
Review at 2, 6 and 12 weeks
Pain scores, function and side effects. Benefit is variable, typically weeks to a few months. Repeat courses are common; cumulative dose is tracked to reduce bladder and liver risk.
When it helps
When a ketamine infusion helps - and when it does not.
The strongest evidence sits with CRPS and neuropathic pain. Ketamine is not the answer for nociceptive pain, opioid-tolerance pain or primary depression.
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CRPS refractory to standard care
The strongest evidence base. Complex regional pain syndrome unresponsive to physiotherapy, sympathetic blocks and standard neuropathic agents.
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Neuropathic pain after nerve injury
Post-traumatic or post-surgical neuropathic pain, including brachial plexus and peripheral nerve injury, where NMDA antagonism can modulate central sensitisation.
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Phantom limb pain
Post-amputation phantom pain with a neuropathic character, particularly when mirror therapy and gabapentinoids have failed.
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Fibromyalgia (selected, limited RCT evidence)
Selected fibromyalgia patients with a strong central sensitisation phenotype. Evidence is more limited than for CRPS; we quote the honest odds.
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Not for pure nociceptive pain
Ketamine is not the answer for mechanical back pain, osteoarthritis or post-op nociceptive pain. NMDA mechanisms do not drive those.
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Not for opioid-tolerance pain alone
Escalating opioid use with poor analgesia needs an opioid rotation and specialist review, not a ketamine infusion as a workaround.
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Not for primary depression (separate pathway)
Ketamine for depression uses a different single-session subanaesthetic model in a psychiatry setting. Do not conflate the two pathways.
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Red flag: active psychosis or unmanaged bipolar
Ketamine can precipitate psychotic symptoms. Active psychosis and unmanaged bipolar disorder are absolute contraindications for a pain infusion.
Protocol options
Outpatient session, inpatient course, and the adjuncts that make it tolerable.
What each option involves, and where a spinal cord stimulator, intrathecal pump or stellate ganglion block may be a better fit before you commit.
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Outpatient single session (0.5 mg/kg / 40 min)
A subanaesthetic IV dose over 40 minutes with continuous BP, HR, SpO2 and sedation monitoring. The standard entry protocol; benefit assessed at 2 weeks.
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Inpatient 4 to 5 day continuous (0.35 mg/kg/h)
Continuous infusion, roughly 100 mg per day, over 4 to 5 days on a monitored ward. Reserved for refractory CRPS. Longer benefit; higher cumulative dose.
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Midazolam adjunct
A small dose of midazolam blunts dissociation and hallucinations. Given on demand if the Cadet dissociation score rises.
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Clonidine adjunct
An alpha-2 agonist that calms sympathetic drive and reduces the psychotomimetic feel of the infusion. A useful alternative to midazolam.
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Booster infusions
Because benefit fades over weeks to months, boosters are common. The interval and dose are set by response, tracking cumulative weekly dose.
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Not ketamine for depression
Depression protocols are 0.5 mg/kg over 40 minutes in a psychiatry setting, sometimes with intranasal esketamine. Different pathway, different consent, different follow-up.
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Alternatives to consider first
Spinal cord stimulator, intrathecal drug pump, stellate ganglion block or lidocaine infusion may be better fits. We flag them before you commit.
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Second-opinion review
A specialist review of your pain history, imaging and prior treatments. Sometimes the answer is a different treatment, not a ketamine infusion.
Our vetted London network
A small panel of pain-medicine consultants, we picked them.
Only a handful of London centres run a chronic-pain ketamine service: King's College Hospital Private Pain, London Pain Clinic at Guy's, HCA The Wellington pain management, Cleveland Clinic London, Nightingale Hospital, and Imperial Private at Charing Cross. Introductions are made privately, once we understand your case.
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Consultants in pain medicine with a dedicated ketamine infusion service
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Hospital-based, monitored settings — not wellness or high-street clinics
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Inpatient CRPS protocols available where indicated, with a named ward team
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Clear urology and hepatology pathways for surveillance on repeat courses
Safety and recovery
What to expect - honestly.
A single infusion in a monitored setting is well tolerated. The real issues are dissociation on the day, and bladder, liver and cognitive risk with repeated high-dose exposure.
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Dissociation and hallucinations
Common during the infusion. We track a Cadet dissociation score; midazolam or clonidine is on hand. Symptoms settle within 30 to 60 minutes of stopping.
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BP and heart rate rise
Ketamine typically raises BP and heart rate by 10 to 20 percent. Continuous monitoring is standard; hypertensive or ischaemic patients need cardiology clearance first.
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Ketamine cystitis with chronic dosing
Cumulative weekly doses above roughly 200 mg carry a real bladder risk: urgency, frequency, pain and, at worst, contracted bladder. Urinalysis at every course.
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Hepatobiliary toxicity
Cholangiopathy has been reported with repeated high-dose exposure. LFTs before every course and a low threshold for MRCP if symptoms develop.
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Cognitive effects with chronic use
Repeated high-dose exposure can cause memory and executive-function problems. Cumulative dose is tracked and boosters spaced accordingly.
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No driving for 24 hours
You must have an escort home after an outpatient session, and you must not drive, operate machinery or sign legal documents for 24 hours.
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Duration of benefit is variable
Weeks to a few months. Some patients get a durable response; others get modest, short-lived relief. We are honest about the odds before you commit.
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Not a cure, not a first line
Ketamine modulates central sensitisation, it does not fix the underlying driver. It sits alongside physiotherapy, psychological support and standard pharmacology.
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Red flags after discharge
Persistent hallucinations, severe headache, chest pain, urinary bleeding or right-upper-quadrant pain — call the unit or go to A&E the same day.
Your infusion note in four parts. Read the last one first.
Whichever protocol was used, the note the consultant sends you keeps to the same shape.
- 01 Header
Indication, protocol and dose
The diagnosis being treated, the protocol used (outpatient single session or inpatient continuous), and the total ketamine dose delivered in milligrams.
- 02 Monitoring
BP, HR, sedation and Cadet dissociation
The maximum BP and HR during infusion, sedation depth, Cadet dissociation score, and any midazolam or clonidine adjunct given.
- 03 Response
Pain scores at baseline, end and follow-up
Numerical rating and functional score at baseline, end of infusion and at 2 weeks. This determines whether a booster or inpatient course follows.
- 04 Plan
Surveillance, boosters and cumulative dose
Read this first: when the next review is, the plan for boosters, and the running cumulative weekly dose used to protect bladder and liver.
Recognised by major UK insurers
Cover for ketamine infusions varies by insurer and by indication. Usually funded for CRPS and refractory neuropathic pain with consultant documentation; fibromyalgia is often declined.
Frequently asked
Everything we get asked about ketamine infusion.
Depression vs pain protocol, insurance, safety, results duration, dissociation and the bladder.
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Is a ketamine infusion for pain the same as ketamine for depression?
No. Ketamine for depression uses a subanaesthetic single-session model, typically 0.5 mg/kg over 40 minutes, delivered in a psychiatry clinic with a mood-focused follow-up. Ketamine for chronic pain is delivered by a pain-medicine consultant, often over a 4 to 5 day inpatient course for refractory CRPS, and is followed up with pain scores and function, not mood. The dose looks similar in the outpatient setting but the pathway, consent and follow-up are different.
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Will my private medical insurance cover it?
Coverage is variable. Some insurers fund ketamine infusions for CRPS, refractory neuropathic pain or phantom limb pain when a pain consultant documents failure of standard therapy. Fibromyalgia and off-label uses are usually declined. We confirm cover with your insurer in writing before booking, and quote the self-pay figure alongside.
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How safe is it?
In a monitored hospital setting with a fit patient, a single subanaesthetic infusion is well tolerated. The real safety issues sit with repeated high-dose exposure: ketamine cystitis above roughly 200 mg per week cumulatively, cholangiopathy with prolonged high-dose use, and cognitive effects. That is why cumulative dose is tracked and urinalysis and LFTs are checked at every course.
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How long will the pain relief last?
Weeks to a few months, and honestly variable. A subset of patients get a durable, useful response; many get modest, short-lived relief and rely on boosters. Inpatient CRPS protocols tend to give a longer benefit than a single outpatient session. If a first infusion gives you nothing at all, a second is unlikely to help.
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What does the dissociation feel like?
Most patients describe a floating, detached feeling with altered time and visual distortion. It is not usually frightening if you are briefed and if the environment is calm. If dissociation becomes uncomfortable, a small dose of midazolam or clonidine settles it. Symptoms clear within 30 to 60 minutes of the infusion ending.
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What is the bladder risk and how is it managed?
Ketamine cystitis — urinary urgency, frequency, pain and, at worst, a contracted bladder — is dose-related and mostly seen with chronic recreational use or repeated high-dose medical courses above roughly 200 mg per week cumulatively. We track cumulative weekly dose, do urinalysis before every course, and refer to urology at the first urinary symptom rather than waiting.
Related
Looking for something else?
Ready to talk?
A ketamine infusion is not a first line, and it is not for everyone. We will tell you which.
Send us a short pain history. Within one working day you will have a consultant recommendation, an honest read on whether ketamine is likely to help, and firm figures across outpatient and inpatient options.