N-methyl-d-aspartate Partial Agonist Enhanced Intensive Cognitive-Behavioral Therapy of Panic Disorder in Adolescents
Panic disorder (PD) can result in significant functional impairment. Studies of cognitive behavioral therapy (CBT) for PD have demonstrated response rates ranging between 38 and 65%. d-cycloserine (DCS), a partial NMDA agonist, may enhance the effects of exposure-based therapy for PD in adults; however, no studies have examined its effect in adolescents with PD. This study examined the feasibility and acceptability of the use of DCS to augment intensive CBT for PD in adolescents. Twenty-four adolescents (ages 12–17) participated in this randomized, double-blinded, placebo-controlled trial, to compare CBT + DCS to CBT + placebo. The results demonstrated the feasibility and acceptability of the treatment to participants. No significant differences were found between the two groups, but both groups showed significant improvement. This is the first investigation of DCS in the treatment of PD in adolescents and it provides initial support for a more extensive study of DCS augmentation of CBT among adolescents with PD.
KeywordsAnxiety Panic disorder d-Cycloserine Cognitive-behavioral therapy Adolescents Outcome
This study was funded by the Brain and Behavior Research Foundation Grant No. 19050 to Ovsanna Leyfer, Ph.D.
- 1.Barlow DH (2001) Anxiety and its disorders: the nature and treatment of anxiety and panic. Guilford Press, New YorkGoogle Scholar
- 2.Merikangas KR, He J-P, Burstein M et al (2010) Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 49:980–989. https://doi.org/10.1016/j.jaac.2010.05.017 CrossRefPubMedPubMedCentralGoogle Scholar
- 6.Mattis SG, Pincus DB (2003) Treatment of SAD and panic disorder in children and adolescents. In: PM Barrett, TH Ollendick (eds) Handbook of interventions that work with children and adolescents: prevention and treatment. Wiley, West Sussex, pp 145–169Google Scholar
- 25.Siegmund A, Golfels F, Finck C et al (2011) D-Cycloserine does not improve but might slightly speed up the outcome of in-vivo exposure therapy in patients with severe agoraphobia and panic disorder in a randomized double blind clinical trial. J Psychiatr Res 45:1042–1047. https://doi.org/10.1016/j.jpsychires.2011.01.020 CrossRefPubMedGoogle Scholar
- 28.Farrell LJ, Waters AM, Boschen MJ et al (2013) Difficult-to-treat pediatric obsessive-compulsive disorder: feasibility and preliminary results of a randomized pilot trial of d-cycloserine-augmented behavior therapy. Depress Anxiety 30:723–731. https://doi.org/10.1002/da.22132 CrossRefPubMedGoogle Scholar
- 32.George D, Mallery P, George D, Mallery P (2003) SPSS for Windows step by step: a simple guide and reference. 11.0 update, 4th edn. Allyn & Bacon, BostonGoogle Scholar
- 33.Silverman W, Albano AM (1996) Anxiety disorders interveiw schedule for DSM-IV. Graywind, New YorkGoogle Scholar
- 44.Guy W (1976) The Clinical Global Impression Scale. In: ECDEU Assessment Manual for Psychopharmacology-Revised. US Dept. of Health, Education & Welfare, ADAMHA, NIMH Psychopharmacology Research Branch, Rockville, MD, pp 218–222Google Scholar
- 45.Mattis SG, Ollendick TH (1997) Panic in children and adolescents: a developmental analysis. Adv Clin Child Psychol 19:74Google Scholar
- 47.Davis ML, Witcraft SM, Smits JAJ et al (2016) d-cycloserine augmentation of exposure therapy: review and new directions. Qual Prim Care 24 PS:30–32Google Scholar
- 53.Mataix-Cols D, Fernández de la Cruz L, Monzani B et al (2017) D-cycloserine augmentation of exposure-based cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders. JAMA Psychiatry 74:501. https://doi.org/10.1001/jamapsychiatry.2016.3955 CrossRefPubMedGoogle Scholar