Psychotherapeutic techniques such as exposure and response prevention therapy are highly effective in treating symptoms of OCD. However, these treatments do not always work for everyone and the challenging nature of behavior therapy and the associated cost cause many people to decline or drop out of treatment.
Given this, there has been a lot of interest in identifying ways that behavior therapy can be made both more effective and accessible for more people. One possibility may be to supplement behavior therapy with medication. A medication that has generated a lot of interest in this respect is the drug D-cycloserine.
D-cycloserine and Exposure and Response Prevention Therapy
D-cycloserine (sold under the name Seromycin) is an antibiotic that was developed to treat tuberculosis. However, it has recently been discovered that D-cycloserine activates specific receptors in a part of the brain called the amygdala; a part of the brain that is crucial to emotional learning such as fear conditioning.
When these receptors are activated by D-cycloserine, both animals and humans are able to “unlearn” being afraid of something they used to fear more quickly than without the drug. Given this, scientists have wondered whether D-cycloserine might help improve exposure-based techniques, including those that are used to treat OCD.
D-cycloserine and OCD
A handful of clinical research studies have taken a closer look at the potential for D-cycloserine to improve exposure-based treatments for OCD. The results of these studies have been mixed. In particular, while One study did not show any change in the outcome in the treatment group, another study did show that that patients treated with D-cycloserine do seem to get better more quickly than those who are taking a placebo or nothing at all.
Although D-cycloserine has only been used experimentally to help treat OCD, these findings are potentially important. As D-cycloserine helps people get better more quickly, it could help to reduce drop-out rates or entice more people to try behavior therapy. As well, as people seem to get better more quickly, they could require a smaller number of treatment sessions. This could make behavior therapy more feasible for people who are unable to afford the 10 or more sessions of behavior therapy that are currently recommended. More research is needed to see if these benefits can actually be realized.
Chasson, G.S., Buhlmann, U., Tolin, D.F., Rao, S.R., Reese, H.E., Rowley, T., Welsh, K.S., & Wilhelm, S. “Need for speed: Evaluating slopes of OCD recovery in behavior therapy enhanced with D-cycloserine” Behaviour Research and Therapy 2010 1-5.
Storch, E.A., Merlo, L.J., Bengston, M., Murphy, T.K., Lewis, M.H., Yang, M.C., Jacob, M., Larson, M., Hirsh, A., Fernandez, M., Geffken, G.R., & Goodman, W.K. “D-cycloserine does not enhance exposure-response prevention therapy in obsessive-compulsive disorder” International Clinical Psychopharmacology 2007 22: 230-237.