Augmentation of behavior therapy with D-cycloserine for obsessive-compulsive disorder

Sabine Wilhelm, Ulrike Buhlmann, David F. Tolin, Suzanne A. Meunier, Godfrey D. Pearlson, Hannah E. Reese, Paul Cannistraro, Michael A. Jenike, Scott L. Rauch

Research output: Contribution to journalArticlepeer-review

300 Scopus citations


Objective: This study examined whether D-cycloserine, a partial agonist at the N-methyl-D-aspartate (NMDA) glutamatergic receptor, enhances the efficacy of behavior therapy for obsessive-compulsive disorder (OCD). Method: A randomized, double-blind, placebo-controlled trial investigating D-cycloserine versus placebo augmentation of behavior therapy was conducted in 23 OCD patients. Patients first underwent a diagnostic interview and pretreatment evaluation, followed by a psychoeducational/treatment planning session. Then they received 10 behavior therapy sessions. Treatment sessions were conducted twice per week. One hour before each of the behavior therapy sessions, the participants received either D-cycloserine, 100 mg, or a placebo. Results: Relative to the placebo group, the D-cycloserine group's OCD symptoms were significantly more improved at mid-treatment, and the D-cycloserine group's depressive symptoms were significantly more improved at posttreatment. Conclusions: These data provide support for the use of D-cycloserine as an augmentation of behavior therapy for OCD and extend findings in animals and other human disorders suggesting that behavior therapy acts by way of long-term potentiation of glutamatergic pathways and that the effects of behavior therapy are potentiated by an NMDA agonist.

Original languageEnglish (US)
Pages (from-to)335-341
Number of pages7
JournalAmerican Journal of Psychiatry
Issue number3
StatePublished - Mar 2008
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health


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