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Antidepressant use with d-Cycloserine may block fear extinction

ABSTRACT FROM: Andersson E, Hedman E, Enander J, et al. d-Cycloserine vs placebo as adjunct to cognitive behavioral therapy for obsessive-compulsive disorder and interaction with antidepressants: a randomized clinical trial. JAMA Psychiatry 2015;72:659–67.

d-Cycloserine (DCS) is a partial agonist at the N -methyl-d-aspartate receptor, which facilitates extinction learning in animal models and augments exposure therapy in humans with anxiety disorders and obsessive-compulsive disorder (OCD).1 In OCD, there have been other small randomised, placebo-controlled trials, in children and adults, examining DCS augmentation of exposure therapy, with inconsistent findings as to whether DCS is superior to placebo at post-treatment or follow-up.2–4 This study, which examined the efficacy of DCS augmentation of a validated internet-based cognitive–behavioural therapy (ICBT) for OCD, is the first large-scale trial on DCS augmentation of CBT for OCD, and contributes to a growing body of literature on the moderators of DCS efficacy, suggesting that DCS is not universally effective.

Andersson and …