Highlighted in Stanford Medical Magazine, the case of Jerry Rivas, a New York native, reported how he was diagnosed with obsessive-compulsive disorder at 15. His life became filled with obsessions about fears of contamination, leading to constant handwashing so severe that he began wearing gloves.
After years of trying medications with little relief, Rivas joined a clinical trial for ketamine for OCD. He reported that after a single infusion, his obsessive thoughts and compulsions were significantly reduced for about two weeks, allowing him to function more like a “regular person”.
However, that effect was temporary rather than a permanent cure. The research around ketamine for OCD shows that while it can quickly relieve symptoms for some people, the improvements often don’t last long without further treatment, integrated therapy, and follow-up sessions [1].
Nonetheless, the research around ketamine therapy for OCD is growing, and Rivas’s short-term relief is just one of many stories, pointing to new pathways of hope for those with OCD who have already tried other treatments.
What is Ketamine Therapy?
Ketamine is a medication originally approved by the FDA as a surgical anesthetic. Researchers have since been exploring ketamine’s potential role in treating mental health conditions, particularly in treatment-resistant cases such as depression or OCD.
Ketamine therapy refers to the supervised, off-label use of ketamine for mental health treatment. Only Esketamine (a nasal spray form of ketamine) is FDA-approved for treatment-resistant depression and must be administered in certified clinics.
Unlike traditional medications that are taken daily and build up slowly, ketamine works quickly for many people, within days or even hours. It is administered under medical supervision, most commonly through an IV infusion, nasal spray, or lozenge, depending on the provider and protocol [2].
Ketamine therapy is often used as part of a broader treatment plan that include psychotherapy, not a stand-alone treatment. For some people, ketamine creates a window where thoughts feel less overwhelming and more flexible, making it easier to engage in therapy and break old patterns [2].
How Does Ketamine Work On The Brain?
Ketamine’s effects on the brain are often explained by the glutamate hypothesis, which states that conditions like OCD, depression, and other mood disorders involve dysregulation of glutamate, the brain’s primary excitatory neurotransmitter.
It’s thought that Ketamine blocks NMDA receptors on inhibitory neurons, leading to a brief surge of glutamate release. This is thought to increase neuroplasticity, strengthen neural connections, and temporarily “reset” rigid brain circuits involved in obsessive thinking and mood regulation [3].
Emerging evidence, however, suggests that ketamine’s impact goes beyond just glutamate. New research shows changes in large-scale brain networks, reductions in connections in fear and control circuits, and effects on neurotrophic factors such as BDNF, which support neural growth and adaptability [4][5].
Carolyn Rodriguez, MD from Columbia University, who ran one of the first clinical trials on ketamine for OCD, says, “Ketamine is a complicated drug that works on many different receptor sites. Researchers have fixated on the NMDA receptor, one of the glutamate-type receptors, but it might not be the only receptor bringing benefit.”[1]
Does Ketamine Work for OCD?
Ketamine has some evidence in case studies and self-reports that it can relieve short-term symptoms of OCD and make individuals more responsive to standard therapies for OCD. However, more research is needed to claim it’s a standard or proven treatment for OCD. It is used off-label, under the discretion of the provider who decides if ketamine therapy could help relieve your OCD symptoms [6].
It is not considered unless you have tried at least 2 or more medications for at least a 6 to 8 week course and have not found relief. Most ketamine providers also require you to attend standard therapy sessions to integrate insights, symptom improvements, and support long-term change.
Is Ketamine Safe for OCD?
Ketamine is typically safe when used in medical settings, but it is still considered off-label and experimental for OCD, so providers often weigh risks and benefits, which is especially important.
Clinics screen patients carefully, monitor vital signs during treatment, and space out sessions to reduce the risk of unwanted side effects. That said, because ketamine is not FDA-approved for OCD, long-term safety data for OCD are limited.
Patients typically report minimal side effects that often resolve within a few hours following the ketamine therapy session. Some of the side effects of ketamine therapy could include:
- Dizziness
- Nausea
- Fatigue
- Headache, blurred vision
- Feeling “spacey” or detached from thoughts or surroundings
- Increase in blood pressure and heart rate
What is The Best Treatment for OCD?
The gold standard treatment for OCD is a specialized form of CBT known as Exposure Response and Prevention (ERP). ERP involves gradually exposing individuals to their OCD triggers, such as thoughts, images, or situations that cause obsessions, while helping them resist performing compulsions.
This helps retrain the brain to recognize triggers as non-threatening, reducing anxiety over time without relying on rituals.
TMS Therapy for OCD
Transcranial Magnetic Stimulation (TMS) is a noninvasive, FDA-approved treatment for adults with OCD who have not found relief from medication or therapy alone. TMS uses targeted magnetic pulses to stimulate specific brain regions involved in OCD, particularly circuits linked to fear, control, and repetitive thinking.
There is a growing interest in integrating TMS with ketamine therapy, though this approach is still emerging and not yet standardized. Ketamine may temporarily increase brain flexibility and reduce symptom severity, while TMS may help reinforce longer-term changes in brain circuits [7].
Some clinicians see ketamine as a way to “open a window” and TMS as a way to help sustain progress, but more research is needed until this becomes a proven OCD protocol.
Ketamine Therapy and OCD Treatment at Maple Mountain
At Maple Mountain Mental Health and Wellness, our compassionate team of clinical psychiatrists and experienced therapists provides evidence-based treatments for OCD, including specialized CBT and advanced off-label ketamine therapy. We can also evaluate you to see if you meet the criteria to receive ketamine therapy. Our licensed mental health team prioritizes your well-being and safety throughout the therapeutic process.
Through a holistic, blended approach, we address each aspect of your health and recovery needs to support long-term healing. Reach out today for an evaluation.
Sources
[1] White, T. 2017. K for OCD. Stanford Medicine Magazine.
[2] Morgan, A. et al. (2021). Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review. BJPsych open, 8(1), e19.
[3] Inserra, A. et al. 2021. Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanisms. Pharmacological Reviews.
[4] Silva, G. et al. 2025. Ketamine’s Role in Neuroinflammation and Neuroprotection Across Neurological and Psychiatric Disorders: A Narrative Review. Pharmaceuticals.
[5] Walter, M. et al. (2025). Association between S-ketamine-induced changes in glutamate levels in the pregenual anterior cingulate cortex and plasma brain-derived neurotrophic factor in healthy subjects. Frontiers in psychiatry, 16, 1662051.
[6] Di Giannantonio, M. et al. (2021). Therapeutic Potentials of Ketamine and Esketamine in Obsessive-Compulsive Disorder (OCD), Substance Use Disorders (SUD), and Eating Disorders (ED): A Review of the Current Literature. Brain sciences, 11(7), 856.
[7] Anugwom, O. (2024). Combination of Transcranial Magnetic Stimulation and Ketamine in Treatment-Resistant Depression: A Systematic Review. Cureus, 16(7), e64712.
