D-Cycloserine Plus Behavioral Therapy Lessens OCD Symptoms

[dut]

This article discusses the use of d-cycloserine 'cos of its effect on NMDA but I wonder if the double hit of it being an abx helps too?

 

anyways... thought it was interesting

 

http://www.medscape.com/viewarticle/571476

[trggirl]

Thanks for posting. Very interesting. I am off to look up Cycloserine and see how that works in the body.

Edited September 10, 2010 by Trg girl

[trggirl]

Camkinase II stimulates Glutamate. If you look up Glutamate metabolism, it uses amines on several of its pathways. Cycloserine has an amine on it. Is Cycloserine helping because it is causing a decrease in Glutamate by increasing its metabolism? Just speculating.

[MomWithOCDSon]

Thanks for the link! There are a couple of other studies available on line concerning d-cycloserine (DCS), too . . . a meta-analysis by Dr. Tolin, studies by Drs. Wilhelm, Storch, etc.

 

I first learned about DCS at the IOCDF conference this past summer; Dr. Eric Storch mentioned it in one of the panel discussions on OCD and comorbid conditions. I guess his group down in Florida only very recently completed a DCS/CBT study with, I think, 32 kids and found that DCS significantly positively impacted the kids' ability to implement tools and techniques they're taught in therapy! I guess the paper has passed peer review and is in publication now.

 

We actually were successful in presenting the research to our psych and he was willing to let us try DCS in combination with therapy with our DS13. Problem is, the dosage is weight-based, and for kids over 50 kilos, the recommended amount is only 50 mg. But the standard pharmacy only produces DCS in 200 mg. tablets because this was the dosage originally formulated back in the 1940s for tuberculosis! It appears the only way you can use this drug currently for the new protocol is to acquire from a hospital pharmacy willing to reformulate it for this particular use.

 

I find this whole thing fascinating, frankly. And the glutamate connection, once again, rearing its head makes me hopeful that all of this research is going to one day meld into a meaningful treatment protocol for all the PANDAS/OCD patients in the future.

[trggirl]

Nancy, did you check into a compounding pharmacy. I know we have several in our area that can do just about anything a doctor asks. Did you check into the safety profile if the dose is being exceeded?

Edited September 10, 2010 by Trg girl

[MomWithOCDSon]

Nancy, did you check into a compounding pharmacy. I know we have several in our area that can do just about anything a doctor asks. Did you check into the safety profile if the dose is being exceeded?

Thanks. Yes, we're looking into that. Unfortunately, the psych has now gotten "cool feet," sensing rightly that, if pharmacies can't readily fill scripts for 50 mg. orders, then this use of the drug isn't exactly "common." On top of which, I guess he reached out to one of the initial studies authors (Raush) whom he happens to know, and this guy's reaction was like, "No, you shouldn't be prescribing this! This is a serious drug." etc. Also, that first study -- the Wilhelm, Raush, et.al. study -- was done on adults, so the translation to using it with kids set off alarms for both Raush and our psych. Neither one of them is familiar with Storch's study.

 

So, we're trying to fill in those gaps now and put our psych in touch with Storch. And/or find another psych affiliated with a teaching hospital who might be more "up-to-date" on the research.

 

Funny how nobody wants to be the first in the pool.