Rapid Symptom Reduction Following Intramuscular Ketamine in Refractory Obsessive-Compulsive Disorder: A Case Report

Area of Science:

• Psychiatry
• Neuroscience
• Pharmacology

Background:

• Obsessive-compulsive disorder (OCD) often co-occurs with depressive disorders, posing treatment challenges.
• Treatment-refractory OCD with comorbid depression is a growing clinical concern.
• Ketamine, a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, is being investigated for rapid-acting interventions.

Purpose of the Study:

• To describe the response of a patient with severe, treatment-refractory OCD and comorbid depression to a single ketamine administration.
• To evaluate the acute efficacy of ketamine in reducing compulsive behaviors.

Main Methods:

• A case report detailing a 27-year-old female patient with severe, treatment-refractory OCD and depressive symptoms.
• Administration of a single intramuscular (IM) dose of ketamine.
• Assessment of compulsive behavior (handwashing duration) before and after ketamine administration.

Main Results:

• The patient experienced an acute reduction in handwashing duration by approximately 97% (from 6-hour sessions to 5-10 minute sessions).
• This reduction was sustained over a 10-day period.
• The patient had previously shown no symptom relief with standard pharmacotherapy.

Conclusions:

• A single IM ketamine administration demonstrated a significant acute reduction in compulsive handwashing behavior.
• Ketamine shows potential as a rapid-acting intervention for severe OCD with comorbid depression.
• Further prospective controlled trials are necessary to confirm efficacy and understand confounding factors.