Abstract
BACKGROUND: About one-third of obsessive-compulsive disorder (OCD) cases show poor response to first-line treatments. Ketamine's role in modulating glutamate, implicated in OCD pathogenesis, warrants investigation. CASES: Four adolescents with treatment-resistant OCD received ketamine infusion (0.5 mg/kg) every other day for six sessions with monitoring using the Children's Yale-Brown Obsessive Compulsive Scale (C-YBCOS) and Clinician-Administered Dissociative State Scale (CADSS). Three patients showed progressive improvement after multiple infusions with maintained benefits at 2-month follow-up. One patient developed ketamine-induced psychosis. CONCLUSION: Ketamine shows promise as adjuvant treatment in adolescent OCD, though psychomimetic risks require careful consideration.