Obsessive-compulsive disorder can consume significant time and energy, making it difficult to concentrate, maintain relationships, complete responsibilities, or feel fully present in daily life.
Intrusive thoughts may create intense distress, while compulsive behaviors can temporarily reduce anxiety but reinforce the cycle over time.
At Pacific Mind Health, we provide personalized psychiatric care for individuals living with OCD, including those whose symptoms occur alongside persistent depression.
Spravato® is not approved by the US Food and Drug Administration (FDA) specifically for obsessive-compulsive disorder. However, emerging research has explored whether esketamine and related ketamine-based treatments could have a role in difficult-to-treat OCD.
Any consideration of Spravato for OCD requires a careful psychiatric evaluation. Our clinicians review your diagnosis, symptoms, previous treatments, current medications, and overall mental health before recommending an appropriate path forward.
Complete our new patient request form to discuss your symptoms and available treatment options.
Spravato® is the brand name for esketamine, a prescription nasal spray that acts on the brain’s glutamate system. This mechanism differs from traditional antidepressants, including selective serotonin reuptake inhibitors commonly prescribed for OCD.
The US Food and Drug Administration (FDA) has approved Spravato for adults with treatment-resistant depression, either by itself or with an oral antidepressant. It is also approved with an oral antidepressant for depressive symptoms in adults with major depressive disorder who are experiencing acute suicidal thoughts or behavior.
These approved indications do not include OCD. Using Spravato for OCD symptoms would therefore be considered off-label and based on a clinician’s judgment, the individual’s diagnoses, and the limited research currently available.
You can learn more about the medication, approved uses, and supervised treatment process on our main Spravato therapy page.
images, or urges that cause distress. Compulsions are repetitive behaviors or mental rituals performed to reduce that distress or prevent a feared outcome.
Common symptoms may include:
People with OCD generally do not want these thoughts or behaviors. They may recognize that the cycle is excessive while still feeling unable to interrupt it.
OCD may also occur alongside anxiety, trauma-related symptoms, or depression. Identifying co-occurring conditions is essential because they can affect both treatment selection and how symptoms are experienced.
Research into Spravato for OCD remains preliminary. Small observational studies, chart reviews, and case reports have described possible reductions in obsessive-compulsive symptoms following esketamine treatment. Some of these patients also had treatment-resistant depression, making it difficult to determine whether improvements were directly related to OCD, depression, or both.
Other studies have examined intravenous or intranasal ketamine rather than FDA-approved Spravato. Although these medications are related, their formulations, administration, dosing, and evidence cannot be treated as interchangeable.
Current research has not yet established:
For these reasons, we do not present Spravato as a replacement for proven OCD treatment. Our clinical team considers the current evidence, your treatment history, and the complete clinical picture before discussing off-label care.
An evaluation may be appropriate for an adult who has significant OCD symptoms alongside an FDA-approved depressive condition, particularly treatment-resistant depression. An OCD diagnosis by itself does not automatically qualify someone for Spravato.
Our assessment may consider:
Contacting Pacific Mind Health begins an evaluation rather than a commitment to treatment. We may recommend Spravato, changes to medication management, psychotherapy, TMS, or another approach based on what we learn.
Cognitive behavioral therapy is an important part of OCD treatment, particularly when it includes exposure and response prevention. Exposure and Response Prevention gradually helps individuals confront feared thoughts or situations while resisting the compulsions normally used to reduce anxiety.
Over time, this process can help weaken the connection between an obsession and the perceived need to perform a ritual. Patients also develop skills for tolerating uncertainty and responding differently to intrusive thoughts.
Our cognitive behavioral therapy services may be included in a broader care plan based on your needs. Spravato, when considered, should not automatically replace therapy or other established interventions.
Spravato cannot be prescribed for unsupervised use at home. Patients self-administer the nasal spray under professional observation at a certified healthcare setting.
Before each session, our team checks your blood pressure and reviews your current symptoms. You remain onsite for at least two hours afterward so we can monitor your response and determine when it is appropriate for you to leave.
Temporary effects may include:
You must arrange transportation home after every appointment. You should not drive, operate machinery, or complete tasks requiring full alertness until the following day after a restful night of sleep.
Our Long Beach office offers a structured clinical environment where each session is professionally supervised.
Spravato is only one potential avenue under investigation. Depending on your diagnosis and previous response, our clinicians may recommend psychiatric medication, psychotherapy, or another interventional service.
TMS therapy is a noninvasive treatment that uses magnetic stimulation to influence targeted brain networks. Certain TMS systems and protocols have received FDA clearance for OCD, making this an important distinction when comparing TMS with off-label esketamine treatment.
We also provide Accelerated TMS for qualifying patients, although eligibility and the protocol used depend on the condition being treated. Our broader treatment services allow us to consider multiple approaches rather than assuming one intervention is right for everyone.
Living with persistent obsessions and compulsions can be exhausting, particularly when previous treatment has not produced enough improvement. Limited success with one approach does not mean that meaningful change is impossible.
At Pacific Mind Health, we provide comprehensive evaluations, individualized recommendations, and compassionate psychiatric support. We will clearly explain what Spravato is approved to treat, what remains experimental, and which alternatives may better match your needs.
Complete our new patient request form to connect with our team. We will review your OCD symptoms, depression history, previous treatments, and current needs before helping you determine an appropriate next step.
