Conditions: Schizophrenia
Keywords: Cognitive Impairment Neuroplasticity D-cycloserine NMDA Anti-Bacterial Agents Mental Disorders Psychotic Disorders Antitubercular Agents Schizophrenia and Disorders with Psychotic Features Schizoaffective Disorder
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 54
Healthy volunteers: no

Brief summary:
This study seeks to examine the effects of D-cycloserine augmentation on cognitive remediation for patients diagnosed with schizophrenia. We will test the hypotheses that D-cycloserine will significantly improve cognitive performance, negative symptoms, and measures of functioning compared to placebo when combined with eight weeks of cognitive remediation. We expect that these effects will persist when assessed at six-month follow up.

Detailed description:
D-cycloserine has been shown to enhance learning in animal models and, in a previous trial, once-weekly D-cycloserine improved negative symptoms in schizophrenia subjects. We set out to test whether DCS combined with cognitive remediation would improve learning of a practiced auditory discrimination task and whether gains would generalize to unpracticed cognitive tasks.

The proposed study consists of an 8-week, placebo-controlled, double-blind, parallel-group trial of D-cycloserine augmentation of cognitive remediation in schizophrenia outpatients. The primary outcome measure is change in performance on the MATRICS cognitive battery composite score after 8 weeks. Secondary outcome measures include a measure of processing speed assessed after weeks 1, 2, 4 \& 8, and changes in negative symptoms and measures of functioning after 4 and 8 weeks. In addition, all outcome measures will be repeated at 6 months to assess persistence of benefit.

Hypotheses:

1. D-cycloserine will significantly improve cognitive performance as measured by the composite score on the MATRICS battery compared to placebo after 8 weeks of cognitive remediation.
2. D-cycloserine will significantly improve negative symptoms as measured by the SANS compared to placebo after 8 weeks when combined with cognitive remediation.
3. D-cycloserine will significantly improve measures of functioning (GAS, QoL and CGI) at 8 weeks compared to placebo when combined with cognitive remediation.
4. D-cycloserine effects on cognition, negative symptoms and functioning will persist compared to placebo when assessed at 6-month follow-up.

Arms:
arm 1: Participants will receive D-cycloserine weekly, one hour before the first cognitive remediation session of the week, for eight weeks. arm 2: Participants will receive placebo weekly, one hour before the first cognitive remediation session of the week, for eight weeks.

Interventions: intervention 1: D-cycloserine intervention 2: Placebo intervention 3: Cognitive Remediation
Intervention descriptions: intervention 1: 50 mg by mouth one hour before first cognitive remediation session each week for eight weeks. intervention 2: Placebo by mouth one hour before first cognitive remediation session each week for eight weeks. intervention 3: 40 one-hour daily sessions of cognitive remediation (Brain Fitness Program) over eight weeks.

Protocol document: