A preliminary study of D-cycloserine augmentation of cognitive-behavioral therapy in pediatric obsessive-compulsive disorder.
BACKGROUND
Research on the neural circuitry underlying fear extinction has led to the examination of D-cycloserine (DCS), a partial agonist at the N-methyl-D-aspartate receptor in the amygdala, as a method to enhance exposure therapy outcome. Preliminary results have supported the use of DCS to augment exposure therapy in adult anxiety disorders; however, no data have been reported in any childhood anxiety disorder. Thus, we sought to preliminarily examine whether weight-adjusted DCS doses (25 or 50 mg) enhanced the overall efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD).


METHODS
Participants were 30 youth (aged 8-17) with a primary diagnosis of OCD. The study design was a randomized, double-blinded, placebo-controlled augmentation trial examining CBT + DCS versus CBT + Placebo (15 youth per group). All patients received seven exposure and response prevention sessions paired with DCS or placebo taken 1 hour before sessions.


RESULTS
Although not significantly different, compared with the CBT + Placebo group, youth in the CBT + DCS arm showed small-to-moderate treatment effects (d = .31-.47 on primary outcomes). No adverse events were recorded.


CONCLUSIONS
These results complement findings in adult OCD and non-OCD anxiety disorders and provide initial support for a more extensive study of DCS augmentation of CBT among youth with OCD.
Storch
Eric A
EA
Department of Pediatrics and Psychiatry, Rothman Center for Neuropsychiatry, University of South Florida, St. Petersburg, FL 33701, USA. estorch@health.usf.edu
Murphy
Tanya K
TK
Goodman
Wayne K
WK
Geffken
Gary R
GR
Lewin
Adam B
AB
Henin
Aude
A
Micco
Jamie A
JA
Sprich
Susan
S
Wilhelm
Sabine
S
Bengtson
Michael
M
Geller
Daniel A
DA
D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003523:Cycloserine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
D003523:Cycloserine
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