Ketamine and Esketamine (Spravato) for Obsessive Compulsive Disorder
Obsessive Compulsive Disorder (OCD) is characterized by recurring thoughts or “obsessions” and behaviors that the person feels the urge to repeat over and over, which are known as “compulsions.” OCD is a common disorder that can be long lasting and termed as chronic. OCD symptoms impair the activities and ability of individuals to live an everyday life making this illness debilitating to many.
How common are these disorders?
Individuals suffering with OCD are estimated to account for 2.5 percent of the population, which means approximately 3 out of 100 people are impacted by this illness. Symptoms of OCD can also present along with one or more other psychiatric disorders, such as mood and anxiety-related disorders. It is estimated that 30 percent of individuals with OCD also have major depression and is suggestive of a shared underlying neurobiology.
Treatment of OCD
The most beneficial treatments for OCD are a combination of circumscribed behavioral therapy and medications. An effective behavioral treatment for OCD is Cognitive Behavior Therapy (CBT) that specifically focuses on Exposure and Response Prevention (ERP). Antidepressant medication, such as Celexa, Prozac, Paxil, and Zoloft, are also effective in OCD. Antidepressants can provide symptomatic relief for patients with OCD, however, approximately 40 – 60 percent will experience minimal to no relief. Psychosurgery, which is a form of brain surgery, has approximately a 64 percent response rate in OCD. Deep brain stimulation has also provided positive results in symptom management in individuals with OCD. Side effects and the high cost of these surgical treatments make it undesirable for many. Therefore, better and faster acting treatments are needed to control OCD symptoms.
Given that patients with OCD may not fully respond to existing treatments, many people remain severely impaired by OCD. Different forms of treatment that allow effective workplace engagement and family-societal functioning is needed.
Ketamine and Esketamine (Spravato) for OCD
Individual patients with OCD and related symptoms, such as depression and anxiety, have reported substantial benefits with a single infusion of low dose ketamine.
One study examined the effects of ketamine in 10 patients with OCD. Those patients who also had comorbid depression experienced significant relief of both depression and OCD symptoms within the first three days following infusion.
Another recent study administered ketamine or placebo to 15 patients with difficult to treat OCD. Ketamine and Esketamine (Spravato) treatment was also associated with a dramatic benefit after only one infusion. Specifically, 50 percent of patients receiving ketamine continued into remission of symptoms after one week.
Take home message
Low dose ketamine infusion may be a useful treatment for patients with OCD. Furthermore, if the patient has comorbid depression, they will also likely experience a relief of these symptoms. Ketamine and Esketamine (Spravato) treatment can provide quick relief for patients suffering from OCD and comorbid depression.
If you or someone you love is suffering from OCD, we encourage you to reach out to COPE to learn more about our innovative, effective, evidence-based treatments. Please call our office at COPE to schedule an appointment.