D-cycloserine augmented exposure therapy for obsessive-compulsive disorder.
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.
Kushner
Matt G
MG
Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota 55454, USA. kushn001@umn.edu
Kim
Suck Won
SW
Donahue
Christopher
C
Thuras
Paul
P
Adson
David
D
Kotlyar
Michael
M
McCabe
James
J
Peterson
Jillian
J
Foa
Edna B
EB
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
D018690:Excitatory Amino Acid Agonists; D016194:Receptors, N-Methyl-D-Aspartate; D003523:Cycloserine