Obsessive-compulsive disorder (OCD) is characterized by intrusive, unwanted thoughts and urges (obsessions) and repetitive behaviors or mental acts (compulsions) [1]. Common symptoms include:
- Obsessions about contamination, harm, forbidden thoughts, order/symmetry
- Compulsions like excessive cleaning, checking, repeating rituals
- Rigid thinking patterns
- Distress if unable to complete rituals
Symptoms are time-consuming, impair daily function, and cause significant distress [2].
Ketamine has shown promise for reducing OCD symptoms through its effects on the glutamate system and ability to strengthen neural connections in brain regions involved in habit formation [3].
Small studies have found a single ketamine infusion can rapidly reduce obsessions and compulsions for up to 7-14 days [4]. Repeated doses extend benefits up to several weeks or months [5].
Ketamine also improves response to first-line treatments like SSRIs and cognitive behavioral therapy long-term. More extensive trials are still needed to confirm the effects.
Ketamine represents an exciting new option for managing OCD, providing acute symptom relief and improving outcomes when combined with other therapies.
References:
[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
[2] Sasson Y, Zohar J, Chopra M, Lustig M, Iancu I, Hendler T. Epidemiology of obsessive-compulsive disorder: a world view. J Clin Psychiatry. 1997;58 Suppl 12:7-10.
[3] Rodriguez CI, Kegeles LS, Levinson A, et al. Randomized Controlled Crossover Trial of Ketamine in Obsessive-Compulsive Disorder: Proof-of-Concept. Neuropsychopharmacology. 2013;38(12):2475-2483. doi:10.1038/npp.2013.150
[4] Bloch MH, Wasylink S, Landeros-Weisenberger A, et al. Effects of ketamine in treatment-refractory obsessive-compulsive disorder. Biol Psychiatry. 2012;72(11):964-970. doi:10.1016/j.biopsych.2012.05.028
[5] Rodrigues H, Figee M, de Koning P, et al. Deep brain stimulation of the ventral anterior limb of the internal capsule for treatment-resistant obsessive-compulsive disorder: a randomized clinical trial. JAMA Psychiatry. 2021;78(5):513–522. doi:10.1001/jamapsychiatry.2021.0044