title: d-cycloserine addition to exposure sessions in the treatment of patients with obsessive-compulsive disorder.
abstract: Preliminary studies have shown that the addition of the partial NMDA-agonist d-cycloserine (DCS) might be promising in enhancing the results of exposure therapy in obsessive-compulsive disorder (OCD). We examined the effect of DCS addition to exposure therapy in a somewhat larger sample of OCD patients with special attention to subgroups, because of the heterogeneity of OCD.
  
  
  
  A randomized, double-blind, placebo controlled trial was conducted in 39 patients with OCD. Patients received 6 guided exposure sessions, once a week. One hour before each session 125mg DCS or placebo was administered.
  
  
  
  Scores on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) declined more in the DCS group than in the placebo group, but the difference did not reach statistical significance (P=0.076, partial η2=0.13). Response percentages also did not differ between the DCS and the placebo group (37% and 15% respectively). In the 'cleaning/contamination' subgroup a significant effect was found in favour of DCS (P=0.033, partial η2=0.297).
  
  
  
  The results of this study did not support the application of DCS to exposure therapy in OCD. Some specific aspects need further investigation: efficacy of DCS in a larger 'cleaning/contamination' (sub-)group, DCS addition only after successful sessions, interaction with antidepressants.
authors.affiliation: Marina de Wolfcenter, Innova, GGz Centraal, Ermelo, The Netherlands. Electronic address: a.de.leeuw@altrecht.nl.
authors.forename: A S
authors.initials: AS
authors.lastname: de Leeuw
authors.affiliation: Marina de Wolfcenter, Innova, GGz Centraal, Ermelo, The Netherlands.
authors.forename: H J G M
authors.initials: HJ
authors.lastname: van Megen
authors.affiliation: Department of psychiatry, Rudolf Magnus institute of neuroscience, university medical center, Utrecht, The Netherlands.
authors.forename: R S
authors.initials: RS
authors.lastname: Kahn
authors.affiliation: Department of psychiatry, Rudolf Magnus institute of neuroscience, university medical center, Utrecht, The Netherlands.
authors.forename: H G M
authors.initials: HG
authors.lastname: Westenberg
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003523:Cycloserine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000628:therapy; D013813:Therapy, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D003523:Cycloserine
keywords: Exposure and response prevention; Obsessive-compulsive disorder; d-cycloserine