NCT01411774

Brief Summary

The investigators are conducting a randomized double-blind placebo-controlled study to assess the efficacy of d-cycloserine augmentation of cognitive-behavioral therapy for the treatment of pediatric obsessive compulsive disorder. This study represents an innovative approach in translating bench research findings into clinical research and testing a new approach for optimizing an effective psychotherapy with a safe non-psychotropic medication.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
142

participants targeted

Target at P25-P50 for phase_3

Timeline
Completed

Started Jun 2011

Longer than P75 for phase_3

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2011

Completed
9 days until next milestone

First Submitted

Initial submission to the registry

June 10, 2011

Completed
2 months until next milestone

First Posted

Study publicly available on registry

August 8, 2011

Completed
4.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2016

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2017

Completed
8 months until next milestone

Results Posted

Study results publicly available

January 23, 2018

Completed
Last Updated

January 23, 2018

Status Verified

October 1, 2017

Enrollment Period

5 years

First QC Date

June 10, 2011

Results QC Date

November 30, 2017

Last Update Submit

December 22, 2017

Conditions

Keywords

Obsessive-compulsive disorderOCD

Outcome Measures

Primary Outcomes (1)

  • Children's Yale-Brown Obsessive-Compulsive Scale.

    The Children's Yale-Brown Obsessive-Compulsive Scale measures the severity of OCD symptoms. There are 10 questions that are summed to arrive at a total score, with higher scores representing more severe OCD symptoms (scores range from 0-40).

    10 weeks

Secondary Outcomes (1)

  • Clinical Global Impression-Severity

    10 weeks

Study Arms (2)

Cognitive-behavioral therapy plus pill placebo

ACTIVE COMPARATOR

This study arm involves the subject receiving 10 sessions of cognitive behavioral therapy with pill placebo taken 1 hour before the session.

Behavioral: Cognitive-behavioral therapyDrug: Pill placebo

Cognitive-behavioral Therapy plus d-cycloserine

EXPERIMENTAL

This study arm involves the subject receiving 10 sessions of cognitive behavioral therapy with d-cycloserine taken 1 hour before the session.

Behavioral: Cognitive-behavioral therapyDrug: d-cycloserine

Interventions

All patients will receive 10 sessions of therapy over 8 weeks using the evidence-based CBT protocol in POTS (2004). Sessions 1-4 will be held twice weekly; sessions 5-10 will be held on a weekly basis. Sessions 1-3 do not include exposures and are devoted to psychoeducation, cognitive therapy, and hierarchy development. Sessions 4-10 involve E/RP exercises specific to each youth.

Also known as: exposure and response prevention, psychotherapy, counseling
Cognitive-behavioral Therapy plus d-cycloserineCognitive-behavioral therapy plus pill placebo

D-cycloserine will be encapsulated into 25mg with identical placebo capsules. Youth will take (1 or 2) DCS or identical placebo capsule 1 hour before sessions 4-10. A 0.7mg/kg dosage corresponds with dosages found to be effective in adult studies (50mg/estimated average adult weight of 70kg=.71mg/kg). Accordingly, doses for this study will be about 0.7mg/kg. Two dosing levels will be used based upon weight ranges to ensure comparable mg/kg levels: children weighing 25-45kg will be given a dosage of 25mg (\~0.56-1.0 mg/kg/day), and children ≥46kg will be given 50mg provided in two 25mg capsules (\~0.50-1.08mg/kg/day). Doses will be given 1 hour before therapy sessions 4-10.

Cognitive-behavioral Therapy plus d-cycloserine

The pill placebo will be identical to the active study medication in every respect (e.g., size, shape, number of capsules, etc.).

Cognitive-behavioral therapy plus pill placebo

Eligibility Criteria

Age7 Years - 17 Years
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17)

You may qualify if:

  • Outpatient youth with obsessive-compulsive disorder between the ages 7-17 years.
  • A Children's Yale-Brown Obsessive-Compulsive Scale score ≥ 16
  • Child has a Full Scale IQ≥85 as assessed on the WASI (within 90% CI).
  • English speaking

You may not qualify if:

  • Receiving concurrent psychotherapy or a past adequate trial of CBT for OCD. Families will have the option of discontinuing such services to enroll in the study.
  • New Treatments: Initiation of an antidepressant within 12 weeks before study enrollment or an antipsychotic 6 weeks before study enrollment. No new alternative medications, nutritionals or therapeutic diets within 6 weeks of study enrollment.
  • Established Treatment changes: Any change in established psychotropic medication (e.g., antidepressants, anxioloytics, stimulant, alpha agonist) within 8 weeks before study enrollment (6 weeks for antipsychotic). Alternative medications must be stable for 6 weeks prior to baseline.
  • Current clinically significant suicidality or individuals who have engaged in suicidal behaviors within 6 months will be excluded.
  • DSM-IV conduct disorder, autism, bipolar, schizophrenia or schizoaffective disorders; or substance abuse in past 6 months using all available information.
  • Youth with hoarding symptoms that are their primary form of OCD.
  • Weight less than 25.0 kg.
  • Epilepsy, renal insufficiency, and current/past history of alcohol abuse.
  • Pregnant or having unprotected sex \[in females\] as the effects of d-cycloserine on pregnancy are unknown.
  • Presence of a significant and/or unstable medical illness that might lead to hospitalization during the study.
  • Known d-cycloserine allergy.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

University of South Florida

St. Petersburg, Florida, 33701, United States

Location

Massachusetts General Hospital

Cambridge, Massachusetts, 02138, United States

Location

Related Publications (1)

  • Storch EA, Murphy TK, Goodman WK, Geffken GR, Lewin AB, Henin A, Micco JA, Sprich S, Wilhelm S, Bengtson M, Geller DA. A preliminary study of D-cycloserine augmentation of cognitive-behavioral therapy in pediatric obsessive-compulsive disorder. Biol Psychiatry. 2010 Dec 1;68(11):1073-6. doi: 10.1016/j.biopsych.2010.07.015.

    PMID: 20817153BACKGROUND

MeSH Terms

Conditions

Obsessive-Compulsive Disorder

Interventions

Cognitive Behavioral TherapyPsychotherapyCounselingCycloserine

Condition Hierarchy (Ancestors)

Anxiety DisordersMental Disorders

Intervention Hierarchy (Ancestors)

Behavior TherapyBehavioral Disciplines and ActivitiesMental Health ServicesCommunity Health ServicesHealth ServicesHealth Care Facilities Workforce and ServicesIsoxazolesAzolesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsOxazolidinonesOxazolesSerineAmino Acids, NeutralAmino AcidsAmino Acids, Peptides, and Proteins

Limitations and Caveats

We did not measure distress ratings within each exposure session, which prohibits examining whether D-cycloserine enhances outcomes when within-session distress reduction is achieved. The sample was primarily of white race/ethnicity.

Results Point of Contact

Title
Dr. Eric Storch
Organization
Baylor College of Medicine

Study Officials

  • Eric Storch, Ph.D.

    University of South Florida

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

June 10, 2011

First Posted

August 8, 2011

Study Start

June 1, 2011

Primary Completion

June 1, 2016

Study Completion

June 1, 2017

Last Updated

January 23, 2018

Results First Posted

January 23, 2018

Record last verified: 2017-10

Locations