Beyond the Raskin Protocol: Ketamine, Lidocaine, and Other Therapies for Refractory Chronic Migraine

Jeffrey J. Mojica, Eric S. Schwenk, Clinton Lauritsen, Stephanie J. Nahas

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Purpose of Review: The purpose of this review is to discuss the available evidence and therapeutic considerations for intravenous drug therapy for refractory chronic migraine. Recent Findings: In carefully monitored settings, the inpatient administration of intravenous lidocaine and ketamine can be successful in treating refractory chronic migraine. Summary: Many patients with refractory chronic migraine have experienced treatment failure with the Raskin protocol. The use of aggressive inpatient infusion therapy consisting of intravenous lidocaine or ketamine, along with other adjunctive medications, has become increasingly common for these patients when all other treatments have failed. There is a clear need for prospective studies in this population comprised of patients who have largely been excluded from other studies.

Original languageEnglish (US)
Article number77
JournalCurrent Pain and Headache Reports
Issue number12
StatePublished - Dec 2021


  • Chronic migraine
  • Ketamine
  • Lidocaine
  • Raskin protocol
  • Refractory headache

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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