Cognitive-behavioural therapy with post-session D-cycloserine augmentation for paediatric obsessive-compulsive...

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• D-cycloserine (DCS) is a partial N-methyl-D-aspartate (NMDA) receptor agonist.
• Preclinical studies suggest DCS can enhance fear extinction learning.
• Obsessive-compulsive disorder (OCD) is often treated with cognitive-behavioural therapy (CBT), including exposure and ritual prevention (ERP).

Purpose of the Study:

• To investigate whether D-cycloserine augments the efficacy of CBT in treating youth with OCD.
• To determine if administering DCS immediately after CBT sessions improves treatment outcomes compared to placebo.

Main Methods:

• A pilot, double-blind, placebo-controlled trial.
• 27 youth diagnosed with OCD were randomized.
• Participants received either 50 mg of D-cycloserine or placebo after each of ten CBT sessions focused on ERP.

Main Results:

• Both D-cycloserine and placebo groups showed significant improvement in OCD symptoms.
• Symptom improvements were maintained at the 1-year follow-up.
• No statistically significant difference in outcomes was observed between the D-cycloserine and placebo groups at any time point.

Conclusions:

• Administering D-cycloserine immediately after CBT sessions does not appear to augment or accelerate treatment effects in youth with OCD.
• Further research may be needed to explore optimal timing or dosage of DCS for OCD treatment.
• CBT alone demonstrates significant efficacy for pediatric OCD.