Ketamine Augmentation of Exposure Response Prevention Therapy for Obsessive Compulsive Disorder
Open accessAbstract
Obsessive-compulsive disorder (OCD) is a disabling disease characterized by intrusive thoughts, with compulsions performed to lessen distress. Many patients with OCD do not respond to first-line intervention, such as serotonin reuptake inhibitors (SRIs) and exposure and response prevention (ERP) therapy. Previous studies have focused on the use of ketamine, a nonselective N-methyl D-aspartate receptor (NMDAR) antagonist, for treatment-resistant OCD. Research has shown that ketamine modulates NMDARs and gamma-aminobutyric acid receptors (GABAR), which are major pathways for contingency-learning, belief updating, and extinction learning. Here, we propose an augmented psychotherapy (AP) protocol combining ERP intervention with administration of ketamine. We describe the theory that NMDAR modulation might directly promote the therapeutic mechanisms involved in exposure and discuss the possibility that ketamine plasticity enhancement might potentiate extinction-based psychotherapy in the treatment of OCD.
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The effect of ketamine on OCD may have been mediated in part by decreasing NMDAR activity and mediating GABA receptors, which are thought to be associated with behavioral dysregulation in OCD.
“This effect may have been mediated in part by decreasing NMDAR activity and mediating GABA receptors, which are thought to be associated with behavioral dysregulation in OCD [110,111]”
From Ketamine in neuropsychiatric disorders: an update (2024) · cites this paper as [110]
Cites
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Ketamine in neuropsychiatric disorders: an update
Johnston, J. N., Kadriu, B., Kraus, C., Henter, I. D., & Zarate, C. A. (2024) · Neuropsychopharmacology · doi:10.1038/s41386-023-01632-1 · Cited by 108 · see citing works
- Authors
- Bottemanne, H., & Arnould, A.
- Affiliations
- Sorbonne Université (FR)
- ORCID
- Bottemanne, Hugo
- Venue
- Unpublished
- Publisher
- Unpublished
- Published
- 2021
- Volume
- 18
- Issue
- 10-12
- Pages
- 9-11
- PMC
- PMC8794478
- OpenAlex
- W4210821340
- Cited by
- 8
- References
- 6
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 3 · 2021: 1
- FWCI
- 1.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- ketamine, exposure and response prevention, obsessive-compulsive disorder, treatment-resistant OCD, NMDA receptor modulation, extinction learning, belief updating, contingency learning, GABA receptors, synaptic plasticity
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