Eric Storch, Ph.D., of the University of South Florida and colleagues recruited 206 youth aged 7 to 17 with a primary diagnosis of OCD (including a score of at least 16 on the Children’s Yale-Brown Obsessive Compulsive Scale [CY-BOCS]) to receive 10 family-based CBT sessions over 8 weeks. After three initial CBT sessions, 142 youth were randomly assigned to take D-cycloserine (25 or 50 mg) or placebo 1 hour before weekly CBT sessions involving E/RP exercises. The CY-BOCS and Clinical Global Impressions–Severity (CGI-S) were administered at randomization, biweekly, midtreatment, and posttreatment.
The researchers found that the D-cycloserine plus CBT group and placebo plus CBT group declined at similar rates per assessment point on the CY-BOCS total score (−2.31 and −2.03, respectively) and CGI-S (−0.29 and −0.23, respectively). They also found no evidence to suggest concomitant antidepressant medication adversely moderated outcomes.
“The meaningful improvement demonstrated by an abbreviated family-based CBT course independent of D-cycloserine … highlights the importance of CBT dissemination,” the authors noted. “[B]ecause D-cycloserine does not universally enhance or expedite symptom reductions for youth with OCD, other safe and tolerable approaches to enhance fear extinction in E/RP should be explored.”
In a related editorial, Stefan Hofmann, Ph.D., of Boston University reflected on what the findings might mean for future studies considering D-cycloserine as an augmentation strategy.
For related information, see the Psychiatric News article “Antidepressants May Inhibit D-Cycloserine From Improving Symptoms in People With OCD.”
(Image: iStock/Izabela Habur)