title: D-cycloserine augmented exposure therapy for obsessive-compulsive disorder.
abstract: BACKGROUND
  D-cycloserine (DCS), a glutamatergic partial N-methyl-d-aspartate (NMDA) agonist, can facilitate extinction learning related to cued fear in animals and humans. We predicted that DCS would accelerate obsession-related distress reduction in patients with obsessive-compulsive disorder (OCD) undergoing extinction-based exposure therapy.
  
  
  METHODS
  We administered DCS (125 mg) or placebo in a double-blind fashion to individuals with OCD approximately 2 hours before each exposure session.
  
  
  RESULTS
  D-cycloserine decreased both the number of exposure sessions required to achieve clinical milestones and the rate of therapy dropout. After four exposure sessions, patients in the DCS group reported significantly greater decreases in obsession-related distress compared with the placebo group; however, after additional sessions, the placebo group tended to catch up.
  
  
  CONCLUSIONS
  D-cycloserine augmentation has the potential to increase the efficiency, palatability, and overall effectiveness of standard exposure therapy for OCD.
authors.affiliation: Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota 55454, USA. kushn001@umn.edu
authors.forename: Matt G
authors.initials: MG
authors.lastname: Kushner
authors.forename: Suck Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Christopher
authors.initials: C
authors.lastname: Donahue
authors.forename: Paul
authors.initials: P
authors.lastname: Thuras
authors.forename: David
authors.initials: D
authors.lastname: Adson
authors.forename: Michael
authors.initials: M
authors.lastname: Kotlyar
authors.forename: James
authors.initials: J
authors.lastname: McCabe
authors.forename: Jillian
authors.initials: J
authors.lastname: Peterson
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003523:Cycloserine / Q000627:therapeutic use*; D004311:Double-Blind Method; D018690:Excitatory Amino Acid Agonists / Q000627:therapeutic use*; D005108:Extinction, Psychological; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy*; D010349:Patient Compliance; D010352:Patient Dropouts; D016194:Receptors, N-Methyl-D-Aspartate / Q000819:agonists; D016896:Treatment Outcome
chemical_list: D018690:Excitatory Amino Acid Agonists; D016194:Receptors, N-Methyl-D-Aspartate; D003523:Cycloserine