Obsessive-Compulsive Disorder (OCD) is a chronic and often debilitating mental health condition characterized by persistent and intrusive thoughts, known as obsessions, as well as repetitive behaviors, referred to as compulsions, performed to alleviate anxiety or distress. According to the National Institute of Mental Health (NIMH), around 1-2% of the U.S. population experiences OCD. This disorder can significantly disrupt an individual’s daily activities, relationships, and overall quality of life.
A new study published in the Journal of Psychopharmacology provides promising insights into ketamine’s potential for individuals with severe OCD who have not responded to standard treatments. Let’s briefly discuss OCD, including its symptoms, treatment options, and ketamine as a possible approach to deliver rapid and effective relief.
OCD symptoms vary in severity and presentation but generally fall into two categories:
Many individuals with OCD understand that their obsessions and compulsions are irrational, yet they still feel driven to complete their rituals, resulting in considerable distress and disruption to daily life.
OCD is primarily treated with a combination of:
While these treatments can be effective, many individuals with OCD do not achieve complete symptom relief. As many as 40% of OCD patients do not respond adequately to standard treatments, prompting researchers to explore alternative therapies such as ketamine.
When administered by a trained medical professional, ketamine therapy is safe with a low risk of side effects. However, it must be done in a clinical setting to ensure proper monitoring.
Ketamine increases glutamate activity and brain-derived neurotrophic factor (BDNF), promoting neuroplasticity—the brain’s ability to form and strengthen new connections, which helps improve mood, emotional regulation, and cognitive flexibility.
Most patients start with an induction phase of six IV infusions over 2-3 weeks. After that, they enter a maintenance phase, during which infusions are spaced out as needed (typically every 2-6 months).
When used responsibly in a clinical setting with close monitoring by a licensed medical provider, ketamine is not linked to addiction. However, recreational misuse may result in dependence.
Ketamine-assisted psychotherapy (KAP) combines ketamine treatments with therapy sessions to help integrate the experience and promote lasting change. Research shows that combining therapy with the medication leads to improved results.
Ketamine, originally developed as an anesthetic, has gained significant attention for its rapid-acting antidepressant effects. Emerging research now suggests it may also be effective for treatment-resistant OCD.
While the first randomized controlled trial in 2013 demonstrated ketamine’s potential for OCD, recent studies have further explored response rates, optimal dosing, and treatment mechanisms.
A 2025 study published in the Journal of Psychopharmacology investigated the efficacy of intramuscular (IM) ketamine for treatment-resistant OCD. This double-blind, active-controlled crossover trial compared two ketamine doses (0.5 mg/kg and 1.0 mg/kg) against fentanyl, a psychoactive control, in patients with severe OCD. The findings provide new insights into ketamine’s therapeutic potential for those who have not responded to traditional treatments.
Key findings from the study include:
These findings are encouraging as they suggest that ketamine could provide rapid relief for individuals with treatment-resistant OCD, a group that often struggles with persistent symptoms despite conventional treatments.
In contrast to conventional OCD therapies focused on serotonin, ketamine acts on the brain’s glutamate system by inhibiting NMDA receptors. This mechanism encourages neuroplasticity, which may lessen the intensity of obsessive thoughts and compulsions.
Ketamine’s ability to induce a temporary dissociative state may also help “reset” intrusive thought patterns, making it easier for individuals to engage in therapy and develop healthier coping mechanisms.
If you or a loved one is considering ketamine therapy for OCD, here’s what to expect:
Ketamine therapy presents a promising treatment for individuals facing treatment-resistant OCD. Although standard treatments such as CBT and SSRIs are the primary options, ketamine serves as a rapid-acting alternative for those who haven't experienced relief through conventional methods. Research indicates that combining ketamine with CBT or ERP may amplify and extend its positive effects on OCD patients.
At Innerbloom Ketamine Therapy, we are committed to providing cutting-edge treatment options for mental health conditions, including OCD. If you are interested in learning more about ketamine therapy and whether it could be a good fit for you, contact us today.
About the Author
Dr. Ray Rivas, a former general and trauma surgeon with over a decade of experience utilizing ketamine, became a ketamine therapy specialist to treat mental health and pain after witnessing its profound impact on his hospital trauma patients and his own mental health. As the founder and medical director of Innerbloom Ketamine Therapy in San Luis Obispo, California, Dr. Rivas applies his extensive medical expertise to provide safe, evidence-based ketamine treatments for mood disorders, including depression, anxiety, PTSD, and chronic pain. His passion lies in helping patients find relief and rediscover hope through personalized, compassionate care.
References:
Beaglehole, B., et al. "Ketamine for Treatment-Resistant Obsessive-Compulsive Disorder: Double-Blind Active-Controlled Crossover Study." Journal of Psychopharmacology, vol. 39, no. 1, 2025, pp. 23-28. SAGE Journals, https://doi.org/10.1177/02698811241301215.
National Institute of Mental Health. Obsessive-Compulsive Disorder (OCD). n.d. U.S. Department of Health and Human Services, https://www.nimh.nih.gov.
Rodriguez, C. I., et al. "Randomized Controlled Crossover Trial of Ketamine in Obsessive-Compulsive Disorder: Proof-of-Concept." Neuropsychopharmacology, vol. 38, 2013, pp. 2475–2483. Springer Nature.
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