D-cycloserine augmentation in behavioral therapy for obsessive-compulsive disorder: a meta-analysis

Area of Science:

• Psychiatry
• Pharmacology
• Clinical Psychology

Background:

• Obsessive-compulsive disorder (OCD) is a debilitating mental health condition.
• Exposure and response prevention (ERP) is a first-line treatment for OCD.
• D-cycloserine (DCS) is an investigational drug being studied as an augmentation to ERP.

Purpose of the Study:

• To evaluate the overall effect of D-cycloserine (DCS) augmentation on exposure and response prevention (ERP) therapy for obsessive-compulsive disorder (OCD).
• To determine if DCS augmentation improves treatment outcomes in OCD patients undergoing ERP therapy.

Main Methods:

• A meta-analysis of clinical studies comparing DCS augmentation with placebo in ERP therapy for OCD.
• Primary outcome measure was the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).
• Data were analyzed using random-effect or fixed-effect models to calculate odds ratios and mean differences with 95% confidence intervals.

Main Results:

• Six studies were included in the meta-analyses.
• DCS augmentation did not show a significant overall effect on ERP therapy for OCD, except at midtreatment.
• A trend toward significantly lower Y-BOCS scores was observed at posttreatment and in a subpopulation receiving DCS before ERP sessions.

Conclusions:

• DCS augmentation may enhance ERP therapy efficacy in reducing OCD symptom severity, particularly in the early stages of treatment.
• Optimizing DCS timing, dosage, and ERP session parameters is crucial for maximizing its therapeutic potential.
• DCS augmentation could potentially reduce treatment costs and improve patient adherence and access to care.