D-cycloserine addition to exposure sessions in the treatment of patients with obsessive-compulsive disorder

作者：de Leeuw A S; van Megen H J G M; Kahn R S; Westenberg H G M

来源：European Psychiatry, 2017, 40: 38-44.

DOI：10.1016/j.eurpsy.2016.06.011

<jats:title>Abstract</jats:title><jats:sec id="S0924933800191795_abs1" sec-type="other"><jats:title>Background</jats:title><jats:p>Preliminary studies have shown that the addition of the partial NMDA-agonist <jats:sc>d</jats:sc>-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.</jats:p></jats:sec><jats:sec id="S0924933800191795_abs2" sec-type="methods"><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec id="S0924933800191795_abs3" sec-type="results"><jats:title>Results</jats:title><jats:p>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 (<jats:italic>P</jats:italic> = 0.076, partial <jats:italic>η</jats:italic><jats:sup>2</jats:sup> = 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 (<jats:italic>P</jats:italic> = 0.033, partial <jats:italic>η</jats:italic><jats:sup>2</jats:sup> = 0.297).</jats:p></jats:sec><jats:sec id="S0924933800191795_abs4" sec-type="conclusions"><jats:title>Conclusions</jats:title><jats:p>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.</jats:p></jats:sec>

• 出版日期2017-2