3300 Cahaba Road, Suite 100
Shades Brook Office Building
Birmingham, Alabama 35223
205-848-2768
8 am-4 pm, Monday-Friday
Obsessive-compulsive disorder (OCD)
Obsessive-compulsive disorder (OCD) is one type of anxiety disorder affecting 1 in 40 adults and 1 in 100 children in the United States. This disorder is characterized by intrusive, recurring thoughts that make the person feel anxious enough to respond with a compulsive behavior. Obsessions may include aggressive thoughts toward others or yourself or a fear of germs. Compulsive actions may include excessive cleaning, hand washing, arranging things in a precise manner or repetitive checking. OCD can interfere with work, interpersonal relationships, and enjoyment of life. The only FDA approved treatment for OCD are selective serotonin re-uptake inhibitors (SSRIs) but the effects of these are limited. Meaningful improvement can take up to 6 to 10 weeks and symptom relief is limited. To find a better way to treat this disorder, a study was conducted at Columbia University treating patients with ketamine infusions.
The Columbia study reported three main findings:
- Participants experienced rapid reduction in obsessive thoughts and this relief lasted for 1 week post infusion compared to the placebo group.
- Ketamine effects on OCD symptoms lasted longer than previously reported
- Glutamate neurotransmission plays an important role in reducing OCD and is consistent with the glutamatergic hypothesis of OCD
At Crestline Health and Wellness, we offer customized low-dose ketamine infusions to treat OCD. We start with a no fee extensive consultation to determine if you are a candidate for ketamine infusion therapy. If ketamine therapy is indicated, we will tailor a treatment plan specifically for you. Ketamine can provide a safe, low risk option with significant relief in a matter of hours when traditional approaches have failed. Ketamine infusions can significantly improve OCD symptoms by stimulating healthy neural function.
A series of infusions followed by maintenance treatments provide greater and longer-lasting relief – with each subsequent infusion in a series building upon the last. We often start with a series of 6 infusions, administered two to three times a week over several weeks for maximum effectiveness. This gives time for increased brain derived neurotropic factor (BDNF) synthesis, neuroplasticity, and a reset for the default mode network (DMN) that contributes to repetitive, intrusive thoughts and behaviors. Each session, is typically a one-hour low-dose infusion. This includes 40 minutes of active infusion and a 20 minute active recovery before being released to go home. In total, patients spend about an hour and a half with us at each visit.
The low-dose infusions typically start around 0.5mg/kg/hr and may be adjusted to the response of the patient. Patients frequently describe the experience of a low-dose infusion as floating or “floaty” and may experience an increased sensitivity to light and sound. The vast majority of patients tolerate these side effects without discomfort and many report them as pleasant. We work hard to avoid any uncomfortable experiences. Although serious side effects are unlikely, we provide physician administration, continuous monitoring, safety equipment,
and protocols consistent with best practices for the procedure and with the Alabama Medical Board Codes for office-based anesthesia.
The initial series is followed by maintenance treatments as needed. Maintenance treatments often start about every 3 to 5 weeks. Over time we work with patients to extend the length of time between these infusions.
Ultimately, the number and frequency of treatments is variable from patient to patient depending on such factors as the severity of the symptoms, the other medications a patient may be on, and the patient’s response to the treatments.
