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Stanford University School of Medicine

Stanford researcher explores use of ketamine to treat severe mental illness

Obsessive-compulsive disorder was debilitating Geuris "Jerry" Rivas, a New York native. He would spend endless hours every day organizing his posters, comic books and videos. He constantly washed his hands, finally having to wear gloves all day to protect him from germs and to prevent him from scrubbing his hands raw.

It affected his school work, he had trouble socializing and his family didn't understand. Eventually, he dropped out of high school due to depression about his OCD.

"It's caused me a great deal of suffering," Rivas told me. "I've tried many, many medications. I've wasted so much of my life."

I chronicled Rivas' personal story in one of a pair of articles on the explosion of research within the psychiatric field into ketamine. Ketamine is a party drug also known as "Special K," but it's also being used as a treatment for hard-to-treat mental disorders, such as OCD, severe depression, bipolar disorder and PTSD. Referred to by some as "the next big thing" in psychiatry, research began more than a decade ago with a National Institutes of Health study that showed ketamine infusions induced dramatic improvements in treatment-resistant depression.

In another piece, I feature Stanford researcher Carolyn Rodriguez, MD, PhD, who was the first to explore ketamine as a treatment for OCD. In 2013, Rodriguez, then at Columbia University, published a landmark trial showing almost immediate reduction of symptoms in patients with OCD following an infusion of the drug. Rivas, who was a participant in that trial, explained what he experienced after his infusion of ketamine during the trial: "I felt like for the first time, I was able to function like a regular person."

Unfortunately, ketamine comes with a whole lot of caveats. It's addictive, hallucinogenic and researchers don't know its long-term effects. The drug is approved by the Food and Drug Administration as an anesthetic but, as a result of the new research, it's now being used off-label in clinics around the country as a high-cost treatment for these mental disorders.

Rodriguez is hesitant to recommend widespread use of ketamine as a psychiatric treatment. She's currently focused on understanding how the drug works in the brain and on looking for possible alternatives that might work along similar molecular pathways but without ketamine's side effects. Still, she understands why many patients are seeking these clinics out. As my story explains:

'The fact that these clinics exist is due to the desperation of patients,' said Rodriguez, who is currently researching the drug's safety as a long-term treatment for OCD. Still, she understands what motivates the clinicians to prescribe the drug now to patients in dire straits -- those who are suicidal or who have tried every possible medication and therapeutic option and continue to suffer each day.

'I see it as a way to treat people whose OCD is very, very severe,' she said. 'People who can't come out of the house, who are suicidal, who have no other options.'

Previously: Studying the genetic architecture of OCD and Tourettes syndrome, and A game changer for the treatment of depression
Photo by Paul Sakuma

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