title: d-Cycloserine enhances durability of social skills training in autism spectrum disorder.
abstract: BACKGROUND
  d-Cycloserine (DCS) enhances extinction learning across species, but it has proven challenging to identify consistent benefit of DCS when added to therapeutic interventions. We conducted a placebo-controlled trial of DCS to potentiate social skills training in autism spectrum disorder (ASD) but found substantial improvement in both the DCS and placebo groups at the conclusion of active treatment. Here, we assess the impact of DCS 11 weeks following active treatment to evaluate the impact of DCS on treatment response durability.
  
  
  METHODS
  Study participants included 60 outpatient youth with ASD, ages 5-11 years, all with IQ above 70, and significantly impaired social functioning who completed a 10-week active treatment phase during which they received weekly single doses of 50 mg of DCS or placebo administered 30 min prior to group social skills training. Following the 10-week active treatment phase, blinded follow-up assessments occurred at week 11 and week 22. The primary outcome measure for our durability of treatment evaluation was the parent-rated social responsiveness scale (SRS) total raw score at week 22.
  
  
  RESULTS
  Analysis of the SRS total raw score demonstrated significant decrease for the DCS group compared to the placebo group (p= 0.042) indicating greater maintenance of treatment effect in the DCS group. DCS was well tolerated, with irritability being the most frequently reported adverse effect in both groups.
  
  
  CONCLUSIONS
  The findings of this study suggest that DCS may help youth with ASD to maintain skills gained during sort-term social skills training. Larger-scale studies with longer follow-up will be necessary to further understand the long-term impact of DCS paired with structured social skills training.
  
  
  BACKGROUND
  ClinicalTrials.gov, NCT01086475.
authors.affiliation: Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229 USA.
authors.forename: Logan K
authors.initials: LK
authors.lastname: Wink
authors.affiliation: Christian Sarkine Autism Treatment Center, Riley Hospital for Children at Indiana University Health and the Indiana University School of Medicine Department of Psychiatry, Indianapolis, IN USA.
authors.forename: Noha F
authors.initials: NF
authors.lastname: Minshawi
authors.affiliation: Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229 USA.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Shaffer
authors.affiliation: Christian Sarkine Autism Treatment Center, Riley Hospital for Children at Indiana University Health and the Indiana University School of Medicine Department of Psychiatry, Indianapolis, IN USA.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Plawecki
authors.affiliation: Dr. David Posey M.D., LLC, Indianapolis, IN USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Posey
authors.affiliation: Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229 USA.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Horn
authors.affiliation: Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229 USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Adams
authors.affiliation: Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229 USA.
authors.forename: Ernest V
authors.initials: EV
authors.lastname: Pedapati
authors.affiliation: Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229 USA.
authors.forename: Tori L
authors.initials: TL
authors.lastname: Schaefer
authors.affiliation: Lurie Center for Autism, Departments of Psychiatry and Pediatrics, Massachusetts General Hospital and MassGeneral Hospital for Children, Harvard Medical School, Boston, MA USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McDougle
authors.affiliation: Christian Sarkine Autism Treatment Center, Riley Hospital for Children at Indiana University Health and the Indiana University School of Medicine Department of Psychiatry, Indianapolis, IN USA.
authors.forename: Naomi B
authors.initials: NB
authors.lastname: Swiezy
authors.affiliation: Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Avenue MLC 4002, Cincinnati, OH 45229 USA.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Erickson
mesh_terms: D000067877:Autism Spectrum Disorder / Q000188:drug therapy* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003523:Cycloserine / Q000008:administration & dosage* / Q000494:pharmacology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007858:Learning / Q000187:drug effects*; D008297:Male; D012720:Severity of Illness Index; D012919:Social Behavior; D016896:Treatment Outcome
chemical_list: D003523:Cycloserine
keywords: Autism; Autism spectrum disorder; Social skills training; d-Cycloserine