Cautious Kudos for Ketamine – Part 1

In May of this year, NAMI sponsored a talk on a new clinic which opened in Raleigh in early July, called Ketamine Treatment Centers of NC, the first of its kind in NC. Ketamine has been around as an anesthetic since the 1960s, once called the buddy drug” because it was available to soldiers on the battlefield during the Vietnam War to inject each other if they had a serious injury. Although still used as an anesthetic, it has many other uses, and has since been shown to be effective (40-70%) for retractable depression, suicidality, the depressed phase of bipolar, PTSD, OCD, and recently for fibromyalgia. Its a synthetically made drug similar to the DM in Robitussin DM (Dextomethorphan).

I was intrigued, by the information, and shared it with Susan, a 67 year old client of mine who had been suffering from extreme OCD for the past 43 years. She had several failed attempts at Exposure/Response Prevention therapy (ERP), the gold standard” in OCD treatment. Although she was able to tolerate the ERP with a reduction in her symptoms while hospitalized in the past, she was unable to follow through with response prevention after she was discharged and returned home. I began to see her in my office in October 2015, and noted that she had a significant trauma history, some of which seemed to relate to her symptoms. We worked together on resolving many of her traumatic experiences; however, the trauma reduction did little to reduce her OCD symptoms.

With nothing to lose, she began ketamine treatment 2 weeks ago and has undergone 4 of the initial 6 treatments. After her 2nd treatment I began ERP in her home to take advantage of the effects of the ketamine, as she reported that for the first time, she was able to experience a vast decrease in the urgency and intensity of her need to clean. I was able to witness her ability to contaminate” areas of her house which she had previously worked to exhaustion to keep uncontaminated. When I saw her walk into that clean room with the white carpet wearing her dirty” shoes, I felt like a mother watching herchild take her first step, and had to hold back my tears, as I knew how significant this was. She then went on to contaminate several other areas of her home, reporting that for the first time in 43 years, she wanted to see what else she could contaminate. She also reported a new optimism that she would be able to one day have people into her home, which she cant have now due to her fear of contamination. While this is early and preliminary, I am excited to see how far combining these two treatments can take her in alleviating this debilitating illness.

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Elizabeth Guarnaccia, LCSW works in private practice in Cary, where she specializes in treating trauma. She is involved on the Board of the NCSCSW as a Programs Committee member and Membership Chair.She can be reached at E[email protected]


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