Australian and New Zealand Clinical Trials Registry: A Novel Approach to Treatment Refractory Childhood Obsessive-Compulsive Disorder: d-Cycloserine–Augmented Behaviour Therapy; http://www.anzctr.org.au/trial_view.aspx?ID=83748; ACTRN12609000370202.
DIFFICULT-TO-TREAT PEDIATRIC OBSESSIVE-COMPULSIVE DISORDER: FEASIBILITY AND PRELIMINARY RESULTS OF A RANDOMIZED PILOT TRIAL OF d-CYCLOSERINE-AUGMENTED BEHAVIOR THERAPY
Article first published online: 30 MAY 2013
© 2013 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 30, Issue 8, pages 723–731, August 2013
How to Cite
Farrell, L. J., Waters, A. M., Boschen, M. J., Hattingh, L., McConnell, H., Milliner, E. L., Collings, N., Zimmer-Gembeck, M., Shelton, D., Ollendick, T. H., Testa, C. and Storch, E. A. (2013), DIFFICULT-TO-TREAT PEDIATRIC OBSESSIVE-COMPULSIVE DISORDER: FEASIBILITY AND PRELIMINARY RESULTS OF A RANDOMIZED PILOT TRIAL OF d-CYCLOSERINE-AUGMENTED BEHAVIOR THERAPY. Depress. Anxiety, 30: 723–731. doi: 10.1002/da.22132
Contract grant sponsor: Australian Rotary Health Research Fund.
- Issue published online: 1 AUG 2013
- Article first published online: 30 MAY 2013
- Manuscript Accepted: 29 APR 2013
- Manuscript Revised: 23 APR 2013
- Manuscript Received: 10 SEP 2012
- Australian Rotary Health Research Fund
- obsessive-compulsive disorder;
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).
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.
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.
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.