BACKGROUND: This study examined the feasibility and preliminary effectiveness of d-cycloserine (DCS)-augmented cognitive behavioral therapy (CBT) for children and adolescents with difficult-to-treat Obsessive Compulsive Disorder, in a double-blind randomized controlled pilot trial (RCT). METHODS:Seventeen children and adolescents (aged 8-18 years) with a primary diagnosis of OCD, which was deemed difficult-to-treat, were randomly assigned to either nine sessions of CBT including five sessions of DCS-augmented exposure and response prevention (ERP) [ERP + DCS] or nine sessions of CBT including five sessions of placebo-augmented ERP [ERP + PBO]. Weight-dependent DCS or placebo doses (25 or 50 mg) were taken 1 hour before ERP sessions. RESULTS: At posttreatment, both groups showed significant improvements with 94% of the entire sample classified as responders. However, a greater improvement in the ERP + DCS relative to the ERP + PBO condition was observed at 1-month follow-up on clinician-rated obsessional severity and diagnostic severity, and parent ratings of OCD severity. There were no changes across time or condition from 1- to 3-month follow-up. CONCLUSIONS: In this preliminary study, DCS-augmented ERP produced significant improvements in OCD severity from posttreatment to 1-month follow-up, relative to a placebo control condition, in severe and difficult-to-treat pediatric OCD. The significant effect on obsessional severity suggests that DCS augmentation might be associated with enhanced modification of obsessional thoughts during ERP, and warrants further investigation.
RCT Entities:
BACKGROUND: This study examined the feasibility and preliminary effectiveness of d-cycloserine (DCS)-augmented cognitive behavioral therapy (CBT) for children and adolescents with difficult-to-treat Obsessive Compulsive Disorder, in a double-blind randomized controlled pilot trial (RCT). METHODS: Seventeen children and adolescents (aged 8-18 years) with a primary diagnosis of OCD, which was deemed difficult-to-treat, were randomly assigned to either nine sessions of CBT including five sessions of DCS-augmented exposure and response prevention (ERP) [ERP + DCS] or nine sessions of CBT including five sessions of placebo-augmented ERP [ERP + PBO]. Weight-dependent DCS or placebo doses (25 or 50 mg) were taken 1 hour before ERP sessions. RESULTS: At posttreatment, both groups showed significant improvements with 94% of the entire sample classified as responders. However, a greater improvement in the ERP + DCS relative to the ERP + PBO condition was observed at 1-month follow-up on clinician-rated obsessional severity and diagnostic severity, and parent ratings of OCD severity. There were no changes across time or condition from 1- to 3-month follow-up. CONCLUSIONS: In this preliminary study, DCS-augmented ERP produced significant improvements in OCD severity from posttreatment to 1-month follow-up, relative to a placebo control condition, in severe and difficult-to-treat pediatric OCD. The significant effect on obsessional severity suggests that DCS augmentation might be associated with enhanced modification of obsessional thoughts during ERP, and warrants further investigation.
Authors: Michael W Otto; M Alexandra Kredlow; Jasper A J Smits; Stefan G Hofmann; David F Tolin; Rianne A de Kleine; Agnes van Minnen; A Eden Evins; Mark H Pollack Journal: Biol Psychiatry Date: 2015-09-25 Impact factor: 13.382
Authors: Monica E Lemmon; Marco Grados; Tina Kline; Carol B Thompson; Syed F Ali; Harvey S Singer Journal: Pediatr Neurol Date: 2015-02-19 Impact factor: 3.372
Authors: Eric A Storch; Sabine Wilhelm; Susan Sprich; Aude Henin; Jamie Micco; Brent J Small; Joseph McGuire; P Jane Mutch; Adam B Lewin; Tanya K Murphy; Daniel A Geller Journal: JAMA Psychiatry Date: 2016-08-01 Impact factor: 21.596
Authors: Michael W Otto; Mark H Pollack; Sheila M Dowd; Stefan G Hofmann; Godfrey Pearlson; Kristin L Szuhany; Ralitza Gueorguieva; John H Krystal; Naomi M Simon; David F Tolin Journal: Depress Anxiety Date: 2016-06-17 Impact factor: 6.505