Digest
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- Progress in Neurology and Psychiatry [ 1367-7543 ] ; 2008-04.
Abstract
The N‐methyl‐D‐aspartic acid (NMDA) agonist D‐cycloserine appears to augment the effectiveness of behavioural therapy: this has been demonstrated in animal models and in patients with a fear of heights and social anxiety disorder. It appears to be an effect on learning rather than mood. By contrast, there have been inconsistent results in patients with obsessive‐compulsive disorder (OCD), as US investigators have again reported (Am J Psychiatry 2008;165:335‐41). Their placebo‐controlled study evaluated the efficacy of adding D‐cycloserine to 10 twice‐weekly behaviour therapy sessions; a 100mg dose was administered one hour before therapy. Of the 23 patients randomised, 16 were also taking other psychotropic medication. D‐cycloserine was associated with a large treatment effect on the Yale‐Brown Obsessive Compulsive Scale mid‐way through the trial but not one month after completion. Active treatment was also associated with significantly fewer depression symptoms immediately after treatment –again, with a large effect size not persisting one month later. No adverse effects were reported. The authors speculate that the enhanced early response might help to reduce the proportion of patients who discontinue therapy early.
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DOI: 10.1002/pnp.69
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