This open-label, randomised crossover trial (n=25) will investigate the effects of intravenous (IV) ketamine (35mg/70kg over one hour) combined with different music conditions—self-selected music, therapist-selected music, or silence—on chronic noncancer pain.
Conducted at the Alan Edwards Pain Management Unit (AEPMU) at Montreal General Hospital and sponsored by McGill University, the study explores whether music can enhance the analgesic (pain-relieving) effects of ketamine.
Participants, all of whom are already prescribed repeated IV ketamine infusions for chronic pain, will undergo four sessions: a baseline treatment-as-usual session followed by three experimental sessions in a randomised order. During each infusion, participants will either listen to their own music, a curated playlist designed for psychedelic therapy, or remain in silence using noise-cancelling headphones. The researchers aim to assess changes in pain intensity, mood, sleep, anxiety, and cognitive flexibility using both quantitative tools and semi-structured interviews. By comparing these conditions, the study hopes to clarify the role of music in modulating the psychological and sensory dimensions of ketamine therapy and optimise protocols for individuals unresponsive to conventional pain treatments.
Trial Details
Intravenous (IV) ketamine is a treatment option for patients with chronic pain that does not respond to standard therapies, primarily working by blocking NMDA receptors in the brain. Beyond pain relief, ketamine can produce dissociative sensations, classifying it as an atypical psychedelic or mind-altering drug, and may enable patients to reprocess their pain similarly to experiences with traditional psychedelics. At the Montreal General Hospital's pain clinic, the investigators have observed patients frequently listening to music during ketamine infusions, and recent research indicates that music-especially when self-selected by patients-might provide additional pain-relieving benefits by influencing central mechanisms related to pain perception and interpretation. This intersection of music and pain relief is garnering substantial scientific interest as recent advances provide more insight into the neuroscience of music and its effects on brain regions involved in emotion, sensation, memory, and pain. This study aims to investigate the effects of music on chronic pain patients undergoing IV ketamine infusions at the Alan Edwards Pain Management Unit (AEPMU), specifically to determine whether the choice of music affects the intensity and duration of ketamine-induced pain relief. During the infusion (lasting 1 hour), patients will listen to a playlist delivered through specialized headphones, which will either consist of their own selected music (preferred music), music chosen by a music therapist, or no music at all, in a randomized order. Patients will track their pain levels throughout the infusion period and in the intervals between treatments (5 weeks) using standardized pain assessment tools. Additionally, the investigators will assess the subjective experiences of ketamine through interviews and qualitative analysis, while documenting and summarizing any adverse effects. The investigators hypothesize that listening to preferred music will enhance both the intensity and duration of pain relief from IV ketamine. To test this, the investigators will recruit patients already receiving repeated IV ketamine infusions for pain management at the AEPMU clinic. The first infusion will take place under usual conditions to establish a baseline. The infusions will occur in a dedicated room equipped with audio technology to ensure an immersive music experience.Trial Number NCT06994559
Sponsors & Collaborators
McGill UniversityPsychedelic research is well underway at McGill University. At the Neurobiological Psychiatry Unit, researchers are assessing the effects of psychedelics at the behavioral, brain circuit, neuronal, and subcellular levels.