Abstract | 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.
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Authors | Lara J Farrell, Allison M Waters, Mark J Boschen, Laetitia Hattingh, Harry McConnell, Ella L Milliner, Nigel Collings, Melanie Zimmer-Gembeck, Doug Shelton, Thomas H Ollendick, Chris Testa, Eric A Storch |
Journal | Depression and anxiety
(Depress Anxiety)
Vol. 30
Issue 8
Pg. 723-31
(Aug 2013)
ISSN: 1520-6394 [Electronic] United States |
PMID | 23722990
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | © 2013 Wiley Periodicals, Inc. |
Chemical References |
- Antimetabolites
- Receptors, N-Methyl-D-Aspartate
- Cycloserine
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Topics |
- Adolescent
- Antimetabolites
(therapeutic use)
- Child
- Cognitive Behavioral Therapy
(methods)
- Combined Modality Therapy
- Cycloserine
(therapeutic use)
- Double-Blind Method
- Extinction, Psychological
- Feasibility Studies
- Female
- Humans
- Implosive Therapy
(methods)
- Male
- Obsessive-Compulsive Disorder
(therapy)
- Pilot Projects
- Receptors, N-Methyl-D-Aspartate
(agonists)
- Treatment Outcome
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