D-Cycloserine Augmented Exposure Therapy for Obsessive-Compulsive Disorder
Received 10 August 2006; received in revised form 15 November 2006; accepted 2 December 2006. published online 25 June 2007.
Background
D-cycloserine (DCS), a glutamatergic partial N-methyl-d-aspartate (NMDA) agonist, can facilitate extinction learning related to cued fear in animals and humans. We predicted that DCS would accelerate obsession-related distress reduction in patients with obsessive-compulsive disorder (OCD) undergoing extinction-based exposure therapy.
Methods
We administered DCS (125 mg) or placebo in a double-blind fashion to individuals with OCD approximately 2 hours before each exposure session.
Results
D-cycloserine decreased both the number of exposure sessions required to achieve clinical milestones and the rate of therapy dropout. After four exposure sessions, patients in the DCS group reported significantly greater decreases in obsession-related distress compared with the placebo group; however, after additional sessions, the placebo group tended to catch up.
Conclusions
D-cycloserine augmentation has the potential to increase the efficiency, palatability, and overall effectiveness of standard exposure therapy for OCD.
aDepartment of Psychiatry, University of Minnesota, Minneapolis, Minnesota
bDepartment of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.
Address reprint requests to Matt G. Kushner, Ph.D., Department of Psychiatry, University of Minnesota, F282-2A West, 2450 Riverside Avenue, Minneapolis, MN 55454
ABSTRACT