Although cognitive behavior therapy (CBT) has shown to be effective for treating children with OCD, not everyone responds to this treatment. As a result, factors that could help make patients more receptive to CBT have been a major interest in research. One of these is related to glutamate (one of the most important neurotransmitters linked to learning, memory, and mood) and N-methyl-D-aspartate (NMDA; a glutamate receptor in the brain).
This study by Dr. Storch and his team aimed to investigate whether adding D-cycloserine (an agonist, or “promoter”, of NMDA) to a course of CBT for pediatric OCD would increase the effectiveness of CBT. 142 children with OCD enrolled in 10 sessions of family-based CBT were randomized to receive either D-cycloserine or a placebo an hour before sessions 4-10. The results showed that for pediatric OCD, D-cycloserine was not better than placebo in increasing CBT’s effectiveness (Storch et al., 2007). This study also contributed to a systematic review of 21 trials (Mataix-Cols et al., 2016) which showed that D-cycloserine generally can make a small improvement to therapy and stressed the need for further research.
*Mataix-Cols, D., Fernández de la Cruz, L., Monzani, B., Rosenfield, D., Andersson, E., Pérez-Vigil, A., Frumento, P., de Kleine, R. A., Difede, J., Dunlop, B. W., Farrell, L. J., Geller, D., Gerardi, M., Guastella, A. J., Hofmann, S. G., Hendriks, G. J., Kushner, M. G., Lee, F. S., Lenze, E. J., Levinson, C. A., … Thuras, P. (2017). D-Cycloserine Augmentation of Exposure-Based Cognitive Behavior Therapy for Anxiety, Obsessive-Compulsive, and Posttraumatic Stress Disorders: A Systematic Review and Meta-analysis of Individual Participant Data. JAMA Psychiatry, 74(5), 501–510. doi:10.1001/jamapsychiatry.2016.3955
*Storch, E. A., Merlo, L. J., Bengtson, M., Murphy, T. K., Lewis, M. H., Yang, M. C., Jacob, M. L., Larson, M., Hirsh, A., Fernandez, M., Geffken, G. R., & Goodman, W. K. (2007). D-Cycloserine does not enhance exposure-response prevention therapy in obsessive-compulsive disorder. International Journal of Clinical Psychopharmacology, 22, 230-237. doi:10.1097/YIC.0b013e32819f8480