Does coadministration of an NMDA receptor antagonist (e.g. Ketamine) work well to prevent the development of tolerance (or hyperalgesia) to opioids (Oxycontin, oxycodone)? If so, do you recommend it?

Recently, I started taking oxycontin and oxycodone again due to the unbearable pain.the tolerance of the drug came very quickly.I also want to avoid falling back into hyperalgesia (the Opiates were hurting me instead of relieving).I don't want to increase the dose of opioids.So, I'm looking for another solution to tolerance and hyperalgesia.I've read that dopioid rotation would be somewhat effective in preventing tolerance but the most promising one I've read about would be an NMDA receptor antagonist (especially ketamine)...in small doses.

In fact, I have tried amytriptiline and gagapentin but I did not tolerate the side effects.I have also tried pregabalin (lyrica) which worked very well at first but my system became tolerant.I was at a very high dose.I stopped it because it did not work at all.So,

i don't try any more this kind of medication because I'm becoming tolerant and some of them have big side effects on me.For the acetaminophen or/and anti-inflammatory I always have some under prescription but the beneficial effect is too little to relieve me.The hot and cold, I use it as often as possible.As for the physiotherapist, physiotherapist, etc...I have done quite a bit in 4 and a half years.I have not been able to have many meetings because I lack money.I continue to do exercises when I have a little less pain.I have at least managed to have an appointment at the multidisciplinary pain clinic in McGill (Montreal). It's a shame that the Outaouais region doesn't have this kind of service.In Ottawa they have a multidisciplinary pain clinic but they don't take patients from Quebec anymore...too bad.I'm going to check with my doctor for other possibilities but I think he's out of his depth.Neuropathic pain located in the back is often very complex to treat.I hope that the specialists in Montreal will be able to help me.Thank you for the information about Ketamine and other solutions.It's much appreciated.

Thank you

I just saw that there could be an interaction between nortriptyline and one of the following agents: cyclobenzaprine, celecoxib, bupropion that I already take:i am seeing my doctor before going to McGill but I think I will wait before making a big change or trying anything.I want to know what the specialists at McGill are going to suggest.My doctor doesn't seem to know what to do anymore.I have 1 month left before the appointment in Montreal.The wait is going to be long especially because of my extreme pain.