title: A randomized controlled trial of cognitive remediation and d-cycloserine for individuals with bipolar disorder.
abstract: BACKGROUND
  Cognitive remediation (CR) has shown significant promise in addressing the cognitive deficits that accompany serious mental illness. However, this intervention does not appear to completely ameliorate the cognitive deficits that accompany these illnesses. D-cycloserine (DCS), an NMDA receptor partial agonist, has been shown to enhance the therapeutic benefits of learning-based psychosocial interventions for psychiatric disorders. Thus, the goal of this study is to examine the utility of combining cognitive remediation and d-cycloserine in the treatment of cognitive deficits among individuals with bipolar disorder.
  
  
  METHODS
  Approximately forty individuals with bipolar disorder will be recruited to participate in this study. Participants will be randomized to one of two study arms: CR + DCS or CR + placebo. The primary outcome for this study is change in cognitive functioning. We will also examine several secondary outcomes, including the rate of change of cognitive functioning, social functioning, and symptomatology.
  
  
  CONCLUSIONS
  Cognitive deficits are a rate-limiting factor in functional recovery among individuals with bipolar disorder. Unfortunately, treatment options for these deficits are limited. The results of the proposed study may reveal a valuable intervention strategy (i.e., CR with concurrent DCS) to improve cognitive functioning among individuals with bipolar disorder. Ultimately, this treatment strategy may prove useful in addressing the cognitive deficits that are ubiquitous across serious mental illnesses.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01934972.
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Nicholas Jk
authors.initials: NJ
authors.lastname: Breitborde
authors.affiliation: Department of Psychology, The University of Arizona, Tucson, AZ USA.
authors.forename: Spencer C
authors.initials: SC
authors.lastname: Dawson
authors.affiliation: Department of Psychology, The University of Arizona, Tucson, AZ USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Woolverton
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: David
authors.initials: D
authors.lastname: Dawley
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Emily K
authors.initials: EK
authors.lastname: Bell
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Kaila
authors.initials: K
authors.lastname: Norman
authors.affiliation: Department of Psychology, The University of Arizona, Tucson, AZ USA.
authors.forename: Angelina
authors.initials: A
authors.lastname: Polsinelli
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Bernstein
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Mirsky
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Pletkova
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Felix
authors.initials: F
authors.lastname: Grucci
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Carly
authors.initials: C
authors.lastname: Montoya
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Bernard
authors.initials: B
authors.lastname: Nanadiego
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Sarabi
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Michael
authors.initials: M
authors.lastname: DePalma
authors.affiliation: Department of Psychiatry, The University of Arizona, Tucson, AZ USA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Moreno