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For individuals with OCD, the first recommended treatment is typically serotonin reuptake inhibitors (SSRIs). However, these medications often provide limited symptom relief. They can also take six to ten weeks to show significant effects and may cause various unpredictable side effects. In some instances, combining SRIs with antipsychotics can enhance effectiveness for a small percentage of patients. However, this approach may further exacerbate side effects. Thus, the need for alternative OCD treatments necessitates research into new medications. Longevity Live Paid Content

Ketamine and Mental Health

Researchers have been looking into the ability of ketamine to treat a variety of disorders, ever since its FDA approval to treat major depression. Ketamine is showing promise as a treatment for a variety of mental disorders, including ADHD, PTSD, and OCD. The drug could be a game changer for millions of people who feel stuck taking antidepressants or other prescriptions every day, or those who don’t find relief from traditional medicines.

Ketamine is now available at a variety of mental health clinics that focus on alternative treatment options, such as Bespoke Treatment. Depression may even be covered by insurance in some cases. As research continues, ketamine is likely to become more accessible to a wider audience for a variety of different conditions.

Ketamine and OCD

The exact cause of OCD is unknown. However, it has been linked to abnormalities in glutamatergic function, which involves the brain’s glutamate neurotransmitter. Imbalances in glutamate production and the presence of glutamatergic compounds are strongly associated with OCD symptoms and behaviors. Similarities between OCD’s pathogenesis and ketamine’s mechanism of action have prompted research into its potential to alleviate OCD symptoms.

Ketamine is an NMDA-glutamate receptor antagonist that primarily regulates glutamate. Its capacity to reduce brain inflammation is believed to contribute to its effect on depression symptoms. Previous studies have demonstrated that ketamine significantly impacts both treated and untreated individuals with OCD.

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2013 Study Tests Ketamine’s Effect on OCD Patients

Carolyn Rodriguez and other researchers from the New York Psychiatric Institute and Columbia University conducted a study in 2013 to further investigate ketamine’s effects on OCD symptoms. The randomized controlled trial involved 15 medication-free adults with OCD who also experienced near-constant obsessions, allowing for a better evaluation of the study drug’s impact on symptom change. The crossover method enabled each participant to serve as their control, reducing the required sample size and variability. In other words, each patient received both a controlled dose and a ketamine dose, and the effects were measured both times.

Participants received two 40-minute intravenous infusions: one with ketamine (0.5 mg/kg) and one with saline, administered one week apart and in a randomized order. The OCD-VAS scale was used to self-rate obsession severity, while an independent evaluator used the Y-BOCS at baseline and one week after each infusion. Several assessments were employed to measure side effects and treatment tolerability, including HDRS-17, CADSS, YMRS, and BPRS.

Eight patients received ketamine first and saline second (arm A), while seven received the opposite (arm B). Arm A patients exhibited significant carryover effects in OCD-VAS and Y-BOCS scores. The mean baseline score for both measures was significantly lower during the second saline infusion compared to all other infusions.

What does the research show?

Additional analyses only considered first-phase data to assess ketamine’s effectiveness independently of carryover effects. Significant differences in OCD-VAS scores were observed at various time points between kid ketamine-first and saline-first groups. Moreover, 50% of ketamine-first patients exhibited a meaningful treatment response based on Y-BOCS scores (≥35% decrease), compared to none of the saline-first patients.

No significant differences in OCD-VAS score reduction were found between those who received ketamine first and second. One week after infusion, one in seven patients met the criteria for a meaningful treatment response (≥35% decrease in Y-BOCS score).

The reported side effects aligned with previous studies using sub-anaesthetic doses of intravenous ketamine. Dissociation symptoms, positive psychotic symptoms, and conceptual disorganization were primarily observed mid-infusion and resolved by the 110-minute post-infusion mark. Physical side effects, such as dizziness, headache, nausea, and vomiting, are also resolved by this time. No side effects were reported one-week post-ketamine infusion.

Ketamine Shows Promising Results

The study’s findings indicate a rapid and significant reduction in obsessions following ketamine infusions, with effects lasting beyond one-week post-infusion. Furthermore, half of the ketamine-first patients experienced a significant compulsion reduction one-week post-infusion. Ketamine’s carryover effects imply a longer-lasting impact on OCD symptoms than previously reported. This suggests that ketamine not only reduces OCD symptoms, but it has a longer-lasting effect than traditional meds.

The results support the glutamatergic hypothesis of OCD and are consistent with prior research on ketamine’s effects on OCD symptoms. This suggests that a drug targeting glutamate neurotransmission, like ketamine, can significantly reduce OCD symptoms even without the presence of an SSRI.

We need further research to understand ketamine’s mechanism of action better and to repeat the trial with a larger sample size. The study adds to a growing body of evidence suggesting that ketamine is an effective and well-tolerated treatment for individuals with OCD, offering a promising alternative to SSRI medications.

Who is the author?

Ben Spielberg, M.S.

Ben Spielberg is the Founder and CEO of Bespoke Treatment. Bespoke Treatment is a mental healthcare organization. Their dedication is to develop cutting-edge solutions for treatment-resistant depression and many other mental health needs.

With his team of passionate mental health specialists, Ben has been a leader in bringing TMS, neurofeedback, and ketamine therapy to Southern California and surrounding areas.

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Ben Spielberg

Ben Spielberg is the Founder and CEO of Bespoke Treatment, a mental healthcare organization dedicated to cutting-edge solutions for treatment-resistant depression and many other mental health needs. With his team of passionate mental health specialists,  Ben has been a leader in bringing TMS, neurofeedback, and ketamine therapy to Southern California and surrounding areas.

The content in this editorial is for general information only and is not intended to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.

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