Can Exposure-Based CBT Extend the Effects of Intravenous Ketamine in Obsessive-Compulsive Disorder?

Article AbstractBecause this piece does not have an abstract, we have provided for your benefit the first 3 sentences of the full text.To the Editor: A single subanesthetic intravenous (IV) dose of ketamine leads to rapid antiobsessional effects in obsessive-compulsive disorder (OCD) patients with near-constant intrusive obsessions, but these effects usually do not persist. We tested whether a brief course of exposure-based cognitive-behavioral therapy (CBT) could extend ketamine's effects in a 2-week pilot open trial and if this effect was maintained (without additional treatment) 2 weeks later. Our rationale was (1) ketamine is reported to enhance plasticity and extinction learning in rodents, and (2) enhanced extinction learning may facilitate CBT gains, as reported in trials that combined CBT with medication thought to facilitate extinction learning (eg, D-cycloserine).