D-Cycloserine Augmentation of Cognitive-Behavioral Therapy: Directions for Pilot Research in Pediatric Obsessive-Compulsive Disorder

Storch, Eric A.; McKay, Dean; Reid, Jeannette M.; Geller, Daniel; Goodman, Wayne K.; Lewin, Adam B.; Murphy, Tanya K.

doi:10.1007/s10566-010-9094-6

Cited by 13 publications

(13 citation statements)

References 79 publications

(89 reference statements)

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“…In fact, research suggests that it may lose its cognitive‐enhancing properties if prescribed over prolonged periods (e.g., Norberg, Krystal, & Tolin, 2008). Finally, unlike many psychotropic medications, the side‐effect profile of DCS is minimal (e.g., Storch et al., 2010a). The side‐effect profile of DCS is equivalent to taking a dose of antibiotic.…”

Section: D‐cycloserine As a Cognitive Enhancer For Augmenting Exposurmentioning

confidence: 99%

“…These participants were defined as “treatment refractory.” Participants are randomised to nine sessions of CBT, including five sessions of ERP (sessions 5–9) with DCS ( n = 9) or with a placebo ( n = 9). As in the Storch et al. (2010a) paediatric study, this study uses two doses dependent on child weight, such that children weighing between 25 and 45 kg take 25 mg of DCS (0.56–1.0 mg/kg/day) and children weighing 46 kg and above receive 50 mg of DCS (0.56–1.08 mg/kg/day).…”

Section: Childhood Ocd and D‐cycloserine‐augmented Exposurementioning

confidence: 99%

“…. nearly negligible” (Storch et al., 2010a). It is possible that DCS may inadvertently strengthen a fear response to a CS if the exposure is unsuccessful.…”

Section: Possible Risks Associated With the Use Of D‐cycloserine In Ymentioning

confidence: 99%

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Using cognitive enhancers to improve the treatment of anxiety disorders in young people: Examining the potential for D‐cycloserine to augment exposure for child anxiety

Byrne

Farrell

Rapee

2011

Clinical Psychologist

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Cognitive-behavioural therapies have shown to be generally effective in treating anxious young people. Yet there is considerable room for improvement, as many clients do not achieve complete remission. This article examines the potential use of D-cycloserine (DCS) to augment exposure-based therapies for anxious young people. DCS is a "cognitive-enhancing" medication believed to consolidate fear-extinction learning into memory. This consolidation may "immunise" against the return of their fear and speed remission. This article describes what DCS is and how it is believed to work. It describes the "translational research" in animals that led to its development for consolidating fear extinction. It reviews the current state of evidence for DCS augmentation and examines the applicability of DCS to enhance psychological treatments for paediatric anxiety disorders. Studies currently under way at Macquarie University and Griffith University in Australia are reviewed. Future directions for this promising research area are briefly considered. Key Points1 Behavioural exposure is an important component of treating clinically severe anxiety in both children and adults. 2 Research suggests DCS can consolidate the fear extinction memory formed during exposure, immunising against later return of fear. 3 Researchers are currently examining whether DCS combined with exposure can speed remission from an anxiety disorder in children.

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Section: D‐cycloserine As a Cognitive Enhancer For Augmenting Exposurmentioning

confidence: 99%

Section: Childhood Ocd and D‐cycloserine‐augmented Exposurementioning

confidence: 99%

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Using cognitive enhancers to improve the treatment of anxiety disorders in young people: Examining the potential for D‐cycloserine to augment exposure for child anxiety

Byrne

Farrell

Rapee

2011

Clinical Psychologist

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“…For example, in a large-scale study of paediatric psychotropic prescribing practices, researchers found that at younger ages, boys were more likely than girls to receive psychotropic medications; however, at older ages this relationship was reversed (Hong & Shepherd, 1996). Unlike many psychotropic medications used to treat children, DCS is considered to be a very low-risk intervention, with the potential for adverse effects being described by Storch et al (2010) as 'almost negligible'. A possible risk raised by some researchers is that DCS could inadvertently strengthen the fear memory, should fear extinction fail to occur during exposure therapy (e.g., Hofmann, 2014).…”

mentioning

confidence: 99%

Factors Associated With Parental Consent to use D-Cycloserine for Child Anxiety

Byrne

Rapee²,

Sweller

2017

Behav. change

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This study examined factors influencing parent willingness to use D-Cycloserine (DCS) for treating child anxiety. N = 222 parents were given information about using DCS to treat anxiety. They were then asked to rate their willingness to allow their child to take DCS/antibiotics for mild anxiety, severe anxiety, or an infection. The associations between willingness to use DCS and parental trait anxiety, demographics, as well as specific concerns regarding the medication, were examined. Parents could also provide written responses regarding their attitudes to DCS, which were analysed for themes. Parents reported concerns regarding potential side-effects from DCS. More severe anxiety was associated with more willingness to consent; however, parents were more willing to use antibiotics to treat an infection than DCS to treat their child's anxiety. The degree of perceived benefit from DCS was most strongly associated with parents’ willingness to use it. Overall, parents expressed mixed views, reporting they would consider using DCS to treat their child; however, they had significant concerns about it. Results suggest providing parents with information explaining how DCS works, its risks and potential benefits may increase its acceptability.

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“…Considering that some children experience significant residual OCD symptoms following an adequate trial of CBT and SSRI (POTS 2004;Freeman et al 2008), the importance of an empirically based second-and third-line treatment algorithm cannot be overstated. Storch et al (2010) highlight a particular augmentation strategy, discussing how D-cycloserine (DCS) might increase the efficacy of exposure-based therapy by enhancing extinction learning. Several DCS studies have been conducted in adults with OCD, suggesting that this agent can enhance the efficiency of exposure therapy (Abramowitz et al 2009;Norberg et al 2008).…”

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confidence: 99%

Recent Developments in the Assessment and Treatment of Pediatric Obsessive-Compulsive Disorder

Berman

Abramowitz

2010

Child Youth Care Forum

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Although tremendous strides have recently been made in the development of assessment and treatment methods for pediatric obsessive-compulsive disorder (OCD), more accurate methods for diagnosis, more effective treatments, and more refined instruments for monitoring progress during therapy are still needed. The present commentary highlights the papers in this series of articles. The excellent work by the contributors to this special edition highlights critical elements and limitations of the assessment process for OCD, the importance of monitoring symptom changes, and possible augmentation strategies for treatment refractory cases. The findings from these studies will almost certainly impact the management of pediatric OCD and lead to further refinements. Keywords Pediatric OCD Á Treatment Á AssessmentAlthough the past few decades have seen tremendous strides in the development of assessment and treatment methods for pediatric obsessive-compulsive disorder (OCD), more accurate methods for diagnosis, more effective treatments, and more refined instruments for monitoring progress during therapy are still needed. Cognitive behavioral therapy (CBT) helps 40-50% of children with OCD achieve clinical remission (POTS 2004;Freeman et al. 2008), yet a significant number of youngsters either cannot tolerate or do not respond to this form of therapy. The papers in this special edition describe exciting methodologies and findings that address the limitations and highlight advances in our understanding of pediatric OCD.To be maximally useful, research on pediatric OCD must involve accurate assessment and diagnosis. Lewin and Piacentini (2010) outline the critical elements of an assessment for pediatric OCD and document various pitfalls and limitations. A major obstacle lies in the dizzying array of clinical disorders that can present with seemingly ''OCD-like'' symptoms. Lewin and Piacentini's clear delineation of the considerations with regard to

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D-Cycloserine Augmentation of Cognitive-Behavioral Therapy: Directions for Pilot Research in Pediatric Obsessive-Compulsive Disorder

Cited by 13 publications

References 79 publications

Using cognitive enhancers to improve the treatment of anxiety disorders in young people: Examining the potential for D‐cycloserine to augment exposure for child anxiety

Using cognitive enhancers to improve the treatment of anxiety disorders in young people: Examining the potential for D‐cycloserine to augment exposure for child anxiety

Factors Associated With Parental Consent to use D-Cycloserine for Child Anxiety

Recent Developments in the Assessment and Treatment of Pediatric Obsessive-Compulsive Disorder

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