
    poor tolerability and low enrollment rate
  
['obsessive-compulsive disorder']
['intranasal ketamine', 'intranasal midazolam']

        Inclusion Criteria:

          -  Age 18-55

          -  Physically healthy and not currently pregnant

          -  Primary diagnosis of OCD

          -  Sufficient severity of symptoms

          -  For all patients on medications, medications dose must be stable for at least 6 weeks
             prior to enrollment. Must discuss with Dr. current medications and doses.

          -  Able to provide consent

        Exclusion Criteria:

          -  First degree relative with schizophrenia

          -  Psychiatric conditions that would make participation unsafe determined by study doctor

          -  Female patients who are either pregnant or nursing

          -  Planning to start EX/RP during the period of the study or those who have completed an
             adequate dose of EX/RP (defined as 8 or more sessions within 2 months) within 8 weeks
             prior to enrollment.

          -  Nasal obstruction or history of nasal surgery

          -  Currently on psychotropic medication or other medication likely to interact with the
             glutamate system

          -  Medical conditions that make participation unsafe

          -  Allergy or intolerance to ketamine or midazolam
      