Trial Outcomes & Findings for D-Cycloserine Augmentation to CBT With Exposure and Response Prevention in Adults and Adolescents With OCD (NCT NCT01172873)

NCT ID: NCT01172873

Last Updated: 2014-08-19

Results Overview

The CYBOCS is a semi-structured measure of Obsessive Compulsive Disorder (OCD) severity with excellent inter-rater reliability, internal consistency, and test-retest reliability. It is validated in those starting at age 7 and used in studies up to age 20.The CYBOCS differs from the adult Yale-Brown Obsessive Compulsive Scale (YBOCS) only in its use of simpler language. CYBOCS scores range from 0-40, with higher scores representing greater severity of symptoms. The CYBOCS will be administered by independent evaluators (IEs) at baseline, session 5, session 10 and the follow-up visit. It will be the primary outcome measure. The CYBOCS checklist will be used to determine symptom dimensions.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

16 participants

Primary outcome timeframe

baseline, visit 5, visit 10, follow-up visit

Results posted on

2014-08-19

Participant Flow

Recruitment was drawn from the broadest possible population with respect to gender and ethnic origin. Internal Review Board(IRB)-approved web/radio/newspaper ads \& flyers were used to recruit patients, as were physician and mental health practitioner referrals.

16 adolescents(12-17yrs) participated in the study. The initial 11 participants received 10 twice-weekly sessions of exposure and response prevention treatment (E/RP) as well as D-Cycloserine(DCS) 50mg at each session. The final 5 participants received 10 twice-weekly sessions of E/RP treatment alone during the active study period.

Participant milestones

Participant milestones
Measure
D-cycloserine + E/RP
The first 11 participants received 10 twice-weekly 60-minute sessions of exposure and response prevention (E/RP) during the active study period. D-Cycloserine 50 mg was administered immediately after each therapy session.
E/RP Alone (no DCS Administration)
The final 5 participants enrolled in the study were assigned to a second treatment arm, to compare E/RP alone to E/RP with D-Cycloserine. These participants received 10 twice-weekly sessions of E/RP without D-Cycloserine. DCS was not administered to this group during the active study period.
Overall Study
STARTED
11
5
Overall Study
COMPLETED
8
3
Overall Study
NOT COMPLETED
3
2

Reasons for withdrawal

Reasons for withdrawal
Measure
D-cycloserine + E/RP
The first 11 participants received 10 twice-weekly 60-minute sessions of exposure and response prevention (E/RP) during the active study period. D-Cycloserine 50 mg was administered immediately after each therapy session.
E/RP Alone (no DCS Administration)
The final 5 participants enrolled in the study were assigned to a second treatment arm, to compare E/RP alone to E/RP with D-Cycloserine. These participants received 10 twice-weekly sessions of E/RP without D-Cycloserine. DCS was not administered to this group during the active study period.
Overall Study
Withdrawal by Subject
3
2

Baseline Characteristics

D-Cycloserine Augmentation to CBT With Exposure and Response Prevention in Adults and Adolescents With OCD

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
D-cycloserine + E/RP
n=11 Participants
Participants in this treatment arm received 10 twice-weekly sessions of E/RP treatment and were administered D-Cycloserine (DCS) immediately after every treatment visit.
E/RP Alone (no DCS Administration)
n=5 Participants
Five participants were enrolled in the second treatment arm as a comparison. The participants received 10 twice-weekly sessions of E/RP treatment alone.
Total
n=16 Participants
Total of all reporting groups
Age, Categorical
<=18 years
11 Participants
n=5 Participants
5 Participants
n=7 Participants
16 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Continuous
15.67 years
STANDARD_DEVIATION 1.32 • n=5 Participants
16.25 years
STANDARD_DEVIATION .96 • n=7 Participants
15.85 years
STANDARD_DEVIATION 1.21 • n=5 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
2 Participants
n=7 Participants
7 Participants
n=5 Participants
Sex: Female, Male
Male
6 Participants
n=5 Participants
3 Participants
n=7 Participants
9 Participants
n=5 Participants
Region of Enrollment
United States
11 participants
n=5 Participants
5 participants
n=7 Participants
16 participants
n=5 Participants

PRIMARY outcome

Timeframe: baseline, visit 5, visit 10, follow-up visit

Population: Data from 14 adolescents were analyzed. One participant was excluded from analyses because he did not receive DCS at every treatment visit. Another was excluded because she was unable to provide reliable data on outcome measures.

The CYBOCS is a semi-structured measure of Obsessive Compulsive Disorder (OCD) severity with excellent inter-rater reliability, internal consistency, and test-retest reliability. It is validated in those starting at age 7 and used in studies up to age 20.The CYBOCS differs from the adult Yale-Brown Obsessive Compulsive Scale (YBOCS) only in its use of simpler language. CYBOCS scores range from 0-40, with higher scores representing greater severity of symptoms. The CYBOCS will be administered by independent evaluators (IEs) at baseline, session 5, session 10 and the follow-up visit. It will be the primary outcome measure. The CYBOCS checklist will be used to determine symptom dimensions.

Outcome measures

Outcome measures
Measure
D-cycloserine + E/RP
n=9 Participants
Treatment involved 10 twice-weekly 60-minute sessions of exposure and response prevention (E/RP) during the active study period. D-Cycloserine 50 mg was administered immediately after each therapy session.
E/RP Alone (no DCS Administration)
n=5 Participants
Participants receiving 10 twice-weekly sessions of E/RP treatment alone. DCS was not administered to this group during the active study period.
Child Yale-Brown Obsessive Compulsive Scale (CY-BOCS) for Adolescents
Baseline CYBOCS
26.56 units on a scale
Standard Deviation 3.91
27.25 units on a scale
Standard Deviation 3.6
Child Yale-Brown Obsessive Compulsive Scale (CY-BOCS) for Adolescents
Session 5 CYBOCS
22.44 units on a scale
Standard Deviation 5.17
19.8 units on a scale
Standard Deviation 7.26
Child Yale-Brown Obsessive Compulsive Scale (CY-BOCS) for Adolescents
Session 10 CYBOCS
19.67 units on a scale
Standard Deviation 8.77
17.2 units on a scale
Standard Deviation 11.55
Child Yale-Brown Obsessive Compulsive Scale (CY-BOCS) for Adolescents
Follow-Up CYBOCS
14.5 units on a scale
Standard Deviation 7.78
22 units on a scale
Standard Deviation 3.61

SECONDARY outcome

Timeframe: baseline, visit 5, visit 10, follow-up visit

Population: Data from 14 adolescents were analyzed. One participant was excluded from analyses because he did not receive DCS at every treatment visit. Another was excluded because she was unable to provide reliable data on outcome measures.

Multidimensional Anxiety Scale for Children (MASC): This is a 39-item self-report that measures anxiety symptoms. It provides a total score, as well as 10 subscales, although only total scores will be analyzed. MASC scores range from 0-117, with higher scores representing greater severity of anxiety symptoms. The MASC and will be administered at baseline, session 5, session 10 and the follow-up visit for adolescents.

Outcome measures

Outcome measures
Measure
D-cycloserine + E/RP
n=9 Participants
Treatment involved 10 twice-weekly 60-minute sessions of exposure and response prevention (E/RP) during the active study period. D-Cycloserine 50 mg was administered immediately after each therapy session.
E/RP Alone (no DCS Administration)
n=5 Participants
Participants receiving 10 twice-weekly sessions of E/RP treatment alone. DCS was not administered to this group during the active study period.
Multidimensional Anxiety Scale for Children (MASC)
Baseline MASC
42.67 units on a scale
Standard Deviation 23.37
52.4 units on a scale
Standard Deviation 23.56
Multidimensional Anxiety Scale for Children (MASC)
Session 5 MASC
40.56 units on a scale
Standard Deviation 19.79
47.4 units on a scale
Standard Deviation 29.72
Multidimensional Anxiety Scale for Children (MASC)
Session 10 MASC
39.33 units on a scale
Standard Deviation 21.42
46.8 units on a scale
Standard Deviation 31.25
Multidimensional Anxiety Scale for Children (MASC)
Follow-Up MASC
NA units on a scale
Standard Deviation NA
Data were not collected at the follow-up visit for this treatment arm.
40.5 units on a scale
Standard Deviation 41.72

SECONDARY outcome

Timeframe: baseline, visit 5, visit 10, follow-up visit

Population: Data from 14 adolescents were analyzed. One participant was excluded from analyses because he did not receive DCS at every treatment visit. Another was excluded because she was unable to provide reliable data on outcome measures. Another was excluded because she was unable to provide reliable data on outcome measures.

Beck's Depression Inventory (BDI): This is a 21-item self report that measures depression symptoms and will be used for both adults and adolescents at baseline, session 5, session 10 and the follow-up visit. BDI-II scores range from 0-63, with higher scores representing greater severity of depression symptoms.

Outcome measures

Outcome measures
Measure
D-cycloserine + E/RP
n=9 Participants
Treatment involved 10 twice-weekly 60-minute sessions of exposure and response prevention (E/RP) during the active study period. D-Cycloserine 50 mg was administered immediately after each therapy session.
E/RP Alone (no DCS Administration)
n=5 Participants
Participants receiving 10 twice-weekly sessions of E/RP treatment alone. DCS was not administered to this group during the active study period.
Beck Depression Inventory (BDI)
Baseline BDI
13.11 units on a scale
Standard Deviation 12.41
12.5 units on a scale
Standard Deviation 0.71
Beck Depression Inventory (BDI)
Session 5 BDI
11.33 units on a scale
Standard Deviation 8.23
4.8 units on a scale
Standard Deviation 2.95
Beck Depression Inventory (BDI)
Session 10 BDI
9.67 units on a scale
Standard Deviation 7.21
4 units on a scale
Standard Deviation 2.35
Beck Depression Inventory (BDI)
Follow-Up BDI
NA units on a scale
Standard Deviation NA
Data were not collected at the follow-up visit for this treatment arm.
4.34 units on a scale
Standard Deviation 1.53

Adverse Events

D-cycloserine + E/RP

Serious events: 1 serious events
Other events: 6 other events
Deaths: 0 deaths

E/RP Alone (no DCS Administration)

Serious events: 1 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
D-cycloserine + E/RP
n=11 participants at risk
Participants in this arm receive 10 twice-weekly 60-minute sessions of Exposure and Response Prevention (E/RP) therapy and 50mg of D-Cycloserine immediately after each therapy session. D-Cycloserine is only administered on days in which therapy sessions are held.
E/RP Alone (no DCS Administration)
n=5 participants at risk
Participants in this arm received twice-weekly 60 minute sessions of E/RP alone for a total of 10 sessions.
Psychiatric disorders
Worsening of OCD symptoms
9.1%
1/11 • Number of events 1
0.00%
0/5
Psychiatric disorders
Suicide attempt
0.00%
0/11
20.0%
1/5 • Number of events 1

Other adverse events

Other adverse events
Measure
D-cycloserine + E/RP
n=11 participants at risk
Participants in this arm receive 10 twice-weekly 60-minute sessions of Exposure and Response Prevention (E/RP) therapy and 50mg of D-Cycloserine immediately after each therapy session. D-Cycloserine is only administered on days in which therapy sessions are held.
E/RP Alone (no DCS Administration)
n=5 participants at risk
Participants in this arm received twice-weekly 60 minute sessions of E/RP alone for a total of 10 sessions.
General disorders
Headache
27.3%
3/11 • Number of events 5
40.0%
2/5 • Number of events 3
Gastrointestinal disorders
GI distress
18.2%
2/11 • Number of events 4
40.0%
2/5 • Number of events 2
Psychiatric disorders
Exacerbation of anxiety
9.1%
1/11 • Number of events 1
20.0%
1/5 • Number of events 1

Additional Information

Moira A. Rynn, M.D.

New York State Psychiatric Institute/Columbia University

Phone: 646-774-5805

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place