Translational Approach to the Understanding and Treatment of Obsessive-Compulsive Disorder (OCD). Can D-Cycloserine Enhance and Stabilize the Treatment-response in Relapsed and Non-responding OCD-patients?

Summary

In this randomized controlled trial (RCT) the investigators experimentally test if patients with Obsessive-Compulsive Disorder (OCD) who have received treatment with exposure and response prevention (ERP), but either relapsed or not responded, profit from the combination of concentrated exposure based treatment (cET) and the NMDA-agonist (N-methyl-d-aspartate) d-cycloserine (DCS), targeting fear relevant areas in amygdala and pre-frontal cortex. The project expects to demonstrate a significant improvement in all groups, and anticipate that a higher proportion of the patients who receive DCS will show a better long-term gain from the treatment, as compared to the placebo group at follow-up (3 mon, 12 mon, and 5 years after treatment). In addition, the project will highlight changes in depression, sleep, global functioning, quality of life, work and social status. Changes in medication and use of health care will be included and related to the main objective of the study.

Timeline

Start

2015-11

Primary completion

2018-09

Completion

2019-02

Publications

• Tjelle K, Hansen B, Solem S, Wheaton MG, Kvale G, Hagen K. Concentrated ERP for Patients With Difficult-to-Treat OCD: Insight as a Predictor of Acute and Long-Term Outcomes. Depress Anxiety. 2025 Dec 11;2025:8960147. doi: 10.1155/da/8960147. eCollection 2025.
• Berg H, Tjelle K, Solem S, Hansen B, Kvale G, Bjorgvinsson T, Hagen K. Motivation in the Bergen 4-day treatment for obsessive-compulsive disorder. BMC Psychiatry. 2025 Oct 9;25(1):958. doi: 10.1186/s12888-025-07218-z.
• Berg H, Tjelle K, Hansen B, Solem S, Bjorgvinsson T, Kvale G, Hagen K. Treatment expectancy and credibility as predictors of concentrated exposure treatment outcomes in patients with difficult-to-treat obsessive-compulsive disorder. BMC Psychiatry. 2025 Mar 25;25(1):275. doi: 10.1186/s12888-025-06737-z.
• Tjelle K, Opstad HB, Solem S, Kvale G, Wheaton MG, Bjorgvinsson T, Hansen B, Hagen K. Patient adherence as a predictor of acute and long-term outcomes in concentrated exposure treatment for difficult-to-treat obsessive-compulsive disorder. BMC Psychiatry. 2024 Apr 30;24(1):327. doi: 10.1186/s12888-024-05780-6.
• Kvale G, Hansen B, Hagen K, Abramowitz JS, Bortveit T, Craske MG, Franklin ME, Haseth S, Himle JA, Hystad S, Kristensen UB, Launes G, Lund A, Solem S, Ost LG. Effect of D-Cycloserine on the Effect of Concentrated Exposure and Response Prevention in Difficult-to-Treat Obsessive-Compulsive Disorder: A Randomized Clinical Trial. JAMA Netw Open. 2020 Aug 3;3(8):e2013249. doi: 10.1001/jamanetworkopen.2020.13249.

Drugs

Indications