Ketamine's double-edged sword: Therapeutic benefits and adverse events in adolescent treatment-resistant OCD - A case series.
Suparna Kumar, Jigyansa Ipsita Pattnaik, Udit Kumar Panda, Tanya Dixit, Aashi Srivastava, Shounak Pal, Bhagyashree Acharya, Meghal Gulati, Jayaprakash Russell Ravan
Indian Journal of Psychiatry June 1, 2025 DOI: 10.4103/indianjpsychiatry_1144_24 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 4 |
| Population | Adolescents with treatment-resistant obsessive-compulsive disorder |
| Intervention | Ketamine infusion |
| Dose | 0.5 mg/kg |
| Duration | Six sessions every other day, with 2-month follow-up |
| Topics | Ketamine Esketamine |
| Keywords | Nmda antagonist Case series Glutamate Treatment-resistant obsessive-compulsive disorder Standard treatments Improvement Ketamine therapy ketamine New investigation Potential Explored Promise Adolescent psychiatry adolescents OCD Transient adverse effects Psychosis Risks |
| Citations | 3 |
| Key findings | Three of four adolescents with treatment-resistant OCD showed progressive improvement after multiple ketamine infusions, with maintained benefits at two-month follow-up, while one patient developed ketamine-induced psychosis. |
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.