Ketamine's double-edged sword: Therapeutic benefits and adverse events in adolescent treatment-resistant OCD - A case series.
Indian journal of psychiatry – June 01, 2025
Source: PubMed
Summary
For one-third of individuals, severe OCD resists standard treatments. A new investigation explored ketamine's potential, as it influences glutamate, a brain chemical linked to OCD. In a case series, four adolescents with treatment-resistant obsessive-compulsive disorder received ketamine, an NMDA antagonist. Remarkably, three showed significant, lasting improvement. However, one experienced transient adverse effects, including psychosis. This suggests ketamine holds promise for adolescent treatment-resistant OCD, despite requiring careful consideration of risks.
Abstract
About one-third of obsessive-compulsive disorder (OCD) cases show poor response to first-line treatments. Ketamine's role in modulating glutamate, implicated in OCD pathogenesis, warrants investigation. Four adolescents with treatment-resistant OCD received ketamine infusion (0.5 mg/kg) every other day for six sessions with monitoring using the Children's Yale-Brown Obsessive Compulsive Scale (C-YBCOS) and Clinician-Administered Dissociative State Scale (CADSS). Three patients showed progressive improvement after multiple infusions with maintained benefits at 2-month follow-up. One patient developed ketamine-induced psychosis. Ketamine shows promise as adjuvant treatment in adolescent OCD, though psychomimetic risks require careful consideration.