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D-Cycloserine as an Adjunct to Internet-CBT for OCD

Phase 4
Completed
Conditions
Obsessive-compulsive Disorder
Interventions
Drug: Placebo
Registration Number
NCT01649895
Lead Sponsor
Christian Rück
Brief Summary

The purpose of this study is to examine if D-Cycloserine is an effective adjunct to internet-based cognitive behaviour therapy for patients with obsessive-compulsive disorder.

Detailed Description

Trial Objectives:

Primary aim is to investigate whether D-Cycloserine gives incremental effects to ICBT in terms of reduced OCD symptoms. Secondary aims are to a) replicate previous findings in that DCS fastens the effects of CBT, b) correlate the fastened effect to overall treatment adherence and c) investigate gene variation and therapeutic factors as predictors of symptom severity, symptom type and treatment response.

Trial Design: Double blinded randomized controlled trial

Dose/Duration: 5 capsules of 50 mg D-Cycloserine or placebo. 1 pcs per week for 5 weeks. All participants also receive Internet-based cognitive behavior therapy for 12 weeks.

Primary Endpoint: Change from W0-W13 and 3-months follow-up.

Efficacy Parameters: Y-BOCS clinician rated.

Safety Parameters: Adverse Events assessed weekly via the internet and also at post-treatment and at 3-months follow-up using face-to-face clinician assessments.

Description of Trial Subjects: Fulfilling diagnostic criteria of OCD not associated with hoarding.

Number of Subjects: 128

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
128
Inclusion Criteria
  • Outpatients
  • Male or female
  • ≥ 18 years
  • Currently living in Stockholm, Uppland, Örebro, Södermanland, Gästrikland, Västmanland and Östergötland county in Sweden.
  • Primary diagnosis of OCD according to the DSM-IV-TR.
  • Signed informed consent
  • Have regular access to a computer with internet access and skills to use the web
  • Have received information about the need of using contraception
Exclusion Criteria
  • Pregnancy or breast feeding
  • Patients unlikely to cooperate fully in the study
  • Patients not able to read or understand the basics of the ICBT self-help material
  • Psychotropic medication changes within two months prior to treatment
  • Completed CBT for OCD within last 12 months
  • Y-BOCS [21] < 16 at Psychiatrist visit (6.2.3)pi
  • OCD symptoms primarily associated with hoarding.
  • Other primary axis I diagnosis according to the Mini-International Neuropsychiatric Interview (MINI) [34]
  • Ongoing substance dependence
  • Lifetime bipolar disorder or psychosis
  • Suicidal ideation
  • Axis II diagnosis that could jeopardize treatment participation
  • Serious physical illness that will be an obstacle in ICBT and DCS
  • Other ongoing psychological treatments that could affect OCD symptoms
  • Epilepsia
  • Renal impairment
  • Hypersensitivity to D-Cycloserine
  • Porphyria
  • Chronic Alcoholism

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPlacebo: 5 pills for 5 weeks, once per week.
D-CycloserineD-CycloserineD-Cycloserine, 5 pills (50mg), once per week in 5 weeks.
Primary Outcome Measures
NameTimeMethod
Yale Brown Obsessive Compulsive Scale (Y-BOCS) (clinician rated)W0,W6,W13. Mid assessments immediately before and after DCS treatment. Long term follow-up at 3-, 12- and 24 months after treatment has ended

Change from Baseline in OCD severity after 12 weeks and at 3-, 12- and 24 months after treatment has ended.

Secondary Outcome Measures
NameTimeMethod
Global assessment of functioning (GAF)W0, W13, Long term follow-up at 3-, 12- and 24 months after treatment has ended

Change from Baseline global functioning after 12 weeks and at 3-, 12- and 24 months after treatment has ended.

Obsessive Compulsive Scale - Revised (OCI-R)W0, W13, Long term follow-up at 3-, 12- and 24 months after treatment has ended

Change from Baseline in OCD severity after 12 weeks and at 3-, 12- and 24 months after treatment has ended.

Clinical global impression (CGI)W0, W13, Long term follow-up at 3-, 12- and 24 months after treatment has ended

Change from Baseline in Clinical global impression after 12 weeks and at 3-, 12- and 24 months after treatment has ended.

Yale Brown Obsessive Compulsive Scale (Y-BOCS)(self-rated)W0, W1,W2,W3,W4,W5,W6,W7,W8,W9,W10,W11,W12, Long term follow-up at 3-, 12- and 24 months after treatment has ended

Weekly change from Baseline in OCD severity during 12 weeks of treatment and at 3-, 12- and 24 months after treatment has ended.

Montgomery Asberg Depression Rating Scale Self-rating (MADRS-S)W0, W13, Long term follow-up at 3-, 12- and 24 months after treatment has ended

Change from Baseline in depression after 12 weeks and at 3-, 12- and 24 months after treatment has ended.

EuroqolW0, W13, Long term follow-up at 3-, 12- and 24 months after treatment has ended

Change from Baseline in quality of life after 12 weeks and at 3-, 12- and 24 months after treatment has ended.

Trimbos and institute of medical technology assessment cost questionnaire for psychiatry (TIC-P)W0, W13, Long term follow-up at 3-, 12- and 24 months after treatment has ended

Change from Baseline in societal costs after 12 weeks and at 3-, 12- and 24 months after treatment has ended.

Adverse eventsW0, W1,W2,W3,W4,W5,W6,W7,W8,W9,W10,W11,W12,W13 Long term follow-up at 3-, 12- and 24 months after treatment has ended

Weekly adverse events reporting during 12 weeks of treatment and at 3-, 12- and 24 months after treatment has ended.

Trial Locations

Locations (1)

M46 Huddinge sjukhus, Internetpsykiatrienheten/mottagningen för tvångssyndrom

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Stockholm, Sweden

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