Ketamine Therapy for OCD

What the Evidence Says About Ketamine for OCD

Interest in ketamine for OCD comes from the glutamate hypothesis of the disorder. The foundational study is Rodriguez et al.'s randomized, double-blind, placebo-controlled crossover trial (Neuropsychopharmacology, 2013): 15 drug-free adults with OCD and near-constant obsessions received two 40-minute IV infusions — saline and ketamine (0.5 mg/kg) — at least a week apart, testing whether a single dose "could achieve rapid anti-obsessional effects."

That proof-of-concept trial reported rapid effects in some patients, but with only 15 participants it remains exactly that — proof of concept. Later work, including a 2025 double-blind active-controlled crossover study in treatment-resistant OCD (Beaglehole et al., J Psychopharmacol), continues to explore the question. OCD is treated off-label at ketamine clinics, usually alongside first-line treatments like SSRIs and exposure-based therapy rather than in place of them.

FDA status: No form of ketamine is FDA-approved for OCD. Generic (racemic) ketamine is FDA-approved as an anesthetic; its use for this condition is off-label, prescribed at a clinician's discretion.

Sources:

• Rodriguez et al., Randomized Controlled Crossover Trial of Ketamine in Obsessive-Compulsive Disorder: Proof-of-Concept (Neuropsychopharmacology 2013)
• Beaglehole et al., Ketamine for treatment-resistant OCD: double-blind active-controlled crossover study (J Psychopharmacol 2025)

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