Serotonin reuptake inhibitors (SRIs), the first-line pharmacological treatment for obsessive-compulsive disorder (OCD), have two limitations: incomplete symptom relief and 2-3 months lag time before clinically meaningful improvement. New medications with faster onset are needed. As converging evidence suggests a role for the glutamate system in the pathophysiology of OCD, we tested whether a single dose of ketamine, a non-competitive N-methyl-D-aspartate (NMDA) glutamate receptor antagonist, could achieve rapid anti-obsessional effects. In a randomized, double-blind, placebo-controlled, crossover design, drug-free OCD adults (n=15) with near-constant obsessions received two 40-min intravenous infusions, one of saline and one of ketamine (0.5 mg\/kg), spaced at least 1-week apart. The OCD visual analog scale (OCD-VAS) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) were used to assess OCD symptoms. Unexpectedly, ketamine\u2019s effects within the crossover design showed significant (p<0.005) carryover effects (ie, lasting longer than 1 week). As a result, only the first-phase data were used in additional analyses. Specifically, those receiving ketamine (n=8) reported significant improvement in obsessions (measured by OCD-VAS) during the infusion compared with subjects receiving placebo (n=7). One-week post-infusion, 50% of those receiving ketamine (n=8) met criteria for treatment response (\u226535% Y-BOCS reduction) vs 0% of those receiving placebo (n=7). Rapid anti-OCD effects from a single intravenous dose of ketamine can persist for at least 1 week in some OCD patients with constant intrusive thoughts. This is the first randomized, controlled trial to demonstrate that a drug affecting glutamate neurotransmission can reduce OCD symptoms without the presence of an SRI and is consistent with a glutamatergic hypothesis of OCD.<\/p>\n","protected":false},"excerpt":{"rendered":"
Abstract Serotonin reuptake inhibitors (SRIs), the first-line pharmacological treatment for obsessive-compulsive disorder (OCD), have two limitations: incomplete symptom relief and 2-3 months lag time before clinically meaningful improvement. New medications with faster onset are needed. As converging evidence suggests a role for the glutamate system in the pathophysiology of OCD, we tested whether a single […]<\/p>\n","protected":false},"author":1,"featured_media":569,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1095","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/test.cornerclix.com\/index.php\/wp-json\/wp\/v2\/posts\/1095","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/test.cornerclix.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/test.cornerclix.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/test.cornerclix.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/test.cornerclix.com\/index.php\/wp-json\/wp\/v2\/comments?post=1095"}],"version-history":[{"count":1,"href":"https:\/\/test.cornerclix.com\/index.php\/wp-json\/wp\/v2\/posts\/1095\/revisions"}],"predecessor-version":[{"id":1096,"href":"https:\/\/test.cornerclix.com\/index.php\/wp-json\/wp\/v2\/posts\/1095\/revisions\/1096"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/test.cornerclix.com\/index.php\/wp-json\/wp\/v2\/media\/569"}],"wp:attachment":[{"href":"https:\/\/test.cornerclix.com\/index.php\/wp-json\/wp\/v2\/media?parent=1095"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/test.cornerclix.com\/index.php\/wp-json\/wp\/v2\/categories?post=1095"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/test.cornerclix.com\/index.php\/wp-json\/wp\/v2\/tags?post=1095"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}