OCD treatment options usually begin with two well studied approaches: a type of talk therapy called exposure and response prevention (ERP), and medications that act on serotonin. These are known as first line treatments, and they help many people. But they do not work the same way for everyone, and some people keep looking for other paths forward.
October is a good time to talk about it. International OCD Awareness Week is observed each October, and many people use the month to learn more.
This guide walks through the main OCD treatment options, why some people look beyond them, and what research currently says about ketamine. It is written to educate, not to diagnose or promise results.
Research reviews describe two main first line OCD treatment options, often used together:
These approaches remain the foundation of OCD care. Anyone thinking about other OCD treatment options should keep their current therapist and prescriber part of the conversation.
Not everyone responds to first line treatment the same way. Some people notice only partial relief. Others find that progress takes longer than they hoped, or that side effects make a medication hard to continue.
When first line care has not provided the results someone hoped for, providers sometimes use the term treatment resistant OCD. It is not a label about the person. It simply describes how a particular approach has gone so far.
Living with that can be exhausting. Many people feel stuck, frustrated, and unsure what to try next. Wanting to learn about more OCD treatment options is a reasonable next step, not a sign of giving up.
Ketamine works differently than SRIs. Instead of acting mainly on serotonin, it affects glutamate, another chemical messenger in the brain. That difference is one reason researchers have studied ketamine for OCD.
A systematic review published in the Harvard Review of Psychiatry looked at the available studies. It noted the potential for fast onset and good tolerability. It also noted that results have been inconsistent, that most studies used a single intravenous session, and that larger, better designed trials are still needed.
That is an honest picture. Ketamine for OCD is an area of active research. It is not a settled answer, and it is not a first line treatment.
Scenic City Neurotherapy is a brain health clinic in Chattanooga, Tennessee, focused on restoring brain function through individualized, research driven care. Our ketamine infusion therapy is delivered through MSKIT® (Minimally Stimulated Ketamine Infusion Therapy), our proprietary protocol. Treatments are administered by Certified Registered Nurse Anesthesiologists (CRNAs) in a comfortable, private setting. We have been serving patients since 2019, and we are an active research site.
You can read more about how we support people exploring care for OCD on our OCD treatment page, or learn about our overall approach.
Every plan starts with a conversation. During a consultation, a provider reviews a person’s history, asks what has been tried so far, and helps explain which options may be worth exploring.
At Scenic City Neurotherapy, ketamine is considered an adjunct to ongoing care, not a replacement for it. Our providers coordinate timing with a patient’s therapist, and no one should change a medication without talking with their prescriber first. You can read more about how we work with other providers.
Ketamine is also not the only option we offer. Transcranial magnetic stimulation (TMS) is a non invasive, drug free treatment with FDA clearance for OCD. A consultation helps weigh how ketamine, TMS, or both might fit a person’s history and goals. Learn more about TMS therapy.
A little preparation can make the conversation more useful. Some questions worth bringing:
What are the most common OCD treatment options? The two most established OCD treatment options are exposure and response prevention therapy and serotonin reuptake inhibitor medications. They are often used together and are considered first line care.
What does treatment resistant OCD mean? It is a term providers sometimes use when first line care has not provided the relief someone hoped for. It describes the treatment experience, not the person.
Is ketamine a first line treatment for OCD? No. Ketamine for OCD is still being studied. Early research points to potential, but results have been inconsistent and larger trials are needed.
Does ketamine replace OCD therapy or medication? No. At Scenic City Neurotherapy, ketamine is considered an adjunct to ongoing care, not a replacement for it. Our providers coordinate with a patient’s therapist, and medication changes should always be made with a prescriber.
Is TMS one of the OCD treatment options? Yes. TMS is a non invasive, drug free treatment with FDA clearance for OCD, and Scenic City Neurotherapy offers it. A consultation can help weigh whether TMS, ketamine, or both may fit.
How do I know if it is time to explore other OCD treatment options? There is no single answer. A good starting point is a conversation with the current care team. Some people also schedule a consultation to learn what other options exist and whether any might fit.
Where can I learn about OCD treatment options in Chattanooga? Scenic City Neurotherapy serves Chattanooga and nearby communities, including Cleveland, Hixson, Ooltewah, Knoxville, Dalton, Ringgold, and Birmingham. Our FAQ page covers common questions, and our team is happy to answer others.
Wondering what your next step could look like? Request a consultation. A provider will reach out within one business day to answer your questions. There is no cost and no obligation.
Ketamine therapy myths are everywhere, and they can keep people from exploring a treatment option that might actually help. Ketamine therapy has grown a lot in recent years, and with that growth has come a lot of misinformation. Some of it comes from outdated ideas about ketamine as a party drug. Some comes from confusion with newer treatments like Spravato®. Here’s a clear look at five of the most common ketamine therapy myths, and what’s actually true.
The reality: The dose, delivery method, and monitoring involved in clinical ketamine therapy are entirely different from recreational use. In a clinical setting, ketamine is administered intravenously in carefully calculated, individualized doses, well below levels associated with recreational use, by trained clinical staff who monitor vital signs throughout the session. The goal isn’t a “high.” It’s a controlled, brief window during which the brain may become more receptive to positive change.
The reality: Traditional antidepressants generally work by adjusting neurotransmitter levels day to day, which is why they often need to be taken continuously to maintain effect. Ketamine’s research is focused on something different: its potential role in supporting neuroplasticity, the brain’s ability to form new neural connections. That’s part of why clinics like ours describe this as brain health care, not just symptom management. It’s about exploring change at a deeper level, not covering up how you feel in the moment.
The reality: Ketamine has been used safely in medical settings, including surgical anesthesia, for decades. In a reputable clinic, treatment is administered by qualified clinical staff. At Scenic City Neurotherapy, that means Certified Registered Nurse Anesthesiologists (CRNAs) with extensive anesthesia experience, in a monitored environment with safety protocols in place before, during, and after each session. That’s a very different picture from unsupervised or at-home use, which carries real risks and isn’t something we recommend or support.
The reality: This is one of the most common, and most discouraging, myths we hear. Traditional antidepressants don’t work the same way for everyone, and a lack of response to one type of treatment doesn’t mean every option has been exhausted. Ketamine therapy is often explored specifically by people who feel like they’ve tried everything else, because its mechanism works differently than standard antidepressants. Exploring another option isn’t giving up. It’s often the next reasonable step.
The reality: Ketamine’s use for treatment-resistant depression and related conditions has been the subject of a growing body of clinical research over the past two decades, including peer-reviewed research published by the National Institutes of Health examining its use in treatment-resistant patients. Scenic City Neurotherapy is also an active research site, contributing data on patient response as part of the broader effort to better understand how individualized ketamine protocols like MSKIT® may support brain health. This is an evolving, evidence-informed field, not a fringe treatment.
Note: Any specific data points about research outcomes or treatment volumes should be confirmed with the clinical team before publishing, since these figures are updated periodically as the research program continues.
The questions below cover a few more common ketamine therapy myths and misunderstandings.
Is ketamine therapy safe? When administered in a clinical setting by trained providers with proper monitoring, ketamine therapy has an established safety profile. Every patient’s history is reviewed individually before treatment begins.
Does ketamine therapy work like a typical antidepressant? No. Traditional antidepressants and ketamine are believed to work through different mechanisms. Ketamine’s research is centered on neuroplasticity, while most antidepressants focus on adjusting neurotransmitter levels over time.
Is ketamine therapy only for people who’ve tried everything else? Many people explore ketamine therapy after other approaches haven’t provided the results they hoped for, but it’s worth discussing during a consultation regardless of where you are in your treatment history.
What makes MSKIT® different from standard ketamine infusion therapy? MSKIT® (Minimally Stimulated Ketamine Infusion Therapy) is Scenic City Neurotherapy’s proprietary, individualized protocol, developed with a focus on personalized dosing and a research-driven approach to brain health rather than a one-size-fits-all infusion.
Have more questions about how ketamine therapy works? Schedule a consultation with our team. We’re happy to walk through what the research says and answer your specific questions.
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Long COVID brain fog is a pattern of memory, focus, and mental fatigue problems that can linger for months after a COVID-19 infection. It’s one of the most commonly reported lingering effects of the virus, and researchers are still working to fully understand why it happens and what helps.
If lingering mental fog has made ordinary tasks feel harder than they used to, you’re not imagining it, and you’re not alone.
“Brain fog” isn’t an official diagnosis. It’s a term people use to describe a cluster of symptoms that can include:
For some people, these symptoms fade within weeks. For others, they persist for months as part of what’s now widely referred to as long COVID.
Researchers are still studying the exact mechanisms behind long COVID brain fog, but a few contributing factors show up repeatedly in the research:
None of these explanations is the whole picture on its own, most researchers believe long COVID brain fog results from a combination of factors, which is part of why it can be difficult to treat with a single, one-size-fits-all approach.
Because long COVID brain fog often overlaps with fatigue, mood changes, and sleep issues, addressing the mental fog alone, without looking at overall brain health, may not lead to lasting improvement. Many people who have researched their options say they’re looking for care that treats the brain as a connected system rather than managing one symptom at a time.
Scenic City Neurotherapy approaches long COVID brain fog as a brain health question, not just a symptom to mask. Our team looks at the whole picture, including neuroplasticity, brain function, and individualized care, rather than offering a generic protocol.
Depending on your history and goals, options explored during a consultation may include:
Every plan starts with a conversation. We don’t assume what’s driving your symptoms, we listen, ask questions, and help you understand what options may be worth exploring.
Note: Scenic City Neurotherapy is an active research site studying treatment response; program details and current data should be confirmed with the clinical team before being cited publicly, as figures are updated periodically.
Is long COVID brain fog permanent? For many people, symptoms improve over time, though timelines vary widely from person to person. Ongoing brain fog is worth discussing with a care team rather than waiting it out indefinitely.
Is brain fog a real medical symptom or just stress? Brain fog is a widely reported and increasingly studied symptom following COVID-19 infection. It’s a real, recognized experience, not “just stress,” even though it isn’t a formal diagnosis on its own.
What kind of provider should I talk to about long COVID brain fog? Because long COVID brain fog can involve several overlapping systems, a brain health-focused clinical team that looks at the full picture, rather than treating a single symptom in isolation, may offer a more complete evaluation of your options.
Where can I learn more about brain health options in Chattanooga? You can learn more about the approach Scenic City Neurotherapy takes to brain health and neuroplasticity, or reach out directly to schedule a consultation and ask questions specific to your situation.
Ready to talk through your options? Schedule a consultation with our team to discuss what a personalized brain health plan could look like for you.
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