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d-Cycloserine Addition to Exposure Sessions in the Treatment of Patients With Obsessive-Compulsive Disorder

Published online by Cambridge University Press:  10 November 2016

A.S. de Leeuw ,
H.J.G.M. van Megen ,
R.S. Kahn  and
H.G.M. Westenberg
A.S. de Leeuw*
Affiliation:
Marina de Wolfcenter, Innova, GGz Centraal, Ermelo, The Netherlands
H.J.G.M. van Megen
Affiliation:
Marina de Wolfcenter, Innova, GGz Centraal, Ermelo, The Netherlands
R.S. Kahn
Affiliation:
Department of psychiatry, Rudolf Magnus institute of neuroscience, university medical center, Utrecht, The Netherlands
H.G.M. Westenberg
Affiliation:
Department of psychiatry, Rudolf Magnus institute of neuroscience, university medical center, Utrecht, The Netherlands
*
* Corresponding author. at: Altrecht Academic Anxiety Center, Nieuwe Houtenseweg 12, 3524 SH, Utrecht, The Netherlands. Tel.: +31 30 2308790 E-mail address:a.de.leeuw@altrecht.nl (A.S. de Leeuw).
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Abstract

Background

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.

Methods

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 125 mg DCS or placebo was administered.

Results

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).

Conclusions

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.

Keywords

d-cycloserineObsessive-compulsive disorderExposure and response prevention
Type
Original article
Information
European Psychiatry , Volume 40 , February 2017 , pp. 38 - 44
Copyright
Copyright © Elsevier Masson SAS 2017

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Footnotes

1

Deceased.

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