A randomized placebo-controlled trial of D-cycloserine to enhance exposure therapy for posttraumatic stress disorder.

Abstract

BACKGROUND:

Posttraumatic stress disorder (PTSD) is a complex and debilitating anxiety disorder, and, although prolonged exposure therapy has been proven effective, many patients remain symptomatic after treatment. In other anxiety disorders, the supplementary use of D-cycloserine (DCS), a partial agonist at the glutamatergic N-methyl-D-aspartate receptor, showed promise in enhancing treatment effects. We examined whether augmentation of prolonged exposure therapy for PTSD with DCS enhances treatment efficacy.

METHODS:

In a randomized, double-blind, placebo-controlled trial we administered 50 mg DCS or placebo 1 hour before each exposure session to 67 mixed trauma patients, recruited from regular referrals, with a primary PTSD diagnosis satisfying DSM-IV criteria.

RESULTS:

Although DCS did not enhance overall treatment effects, the participants having received DCS did show a stronger treatment response. Exploratory session-by-session analyses revealed that DCS yielded higher symptom reduction in those participants that had more severe pretreatment PTSD and needed longer treatment.

CONCLUSIONS:

The present study found preliminary support for the augmentation of exposure therapy with DCS, specifically for patients with more severe PTSD needing longer treatment.

• Authors: Rianne A de Kleine, Gert-Jan Hendriks, Wendy J C Kusters, Theo G Broekman, Agnes van Minnen
• Journal: Biological psychiatry (Biol Psychiatry) Vol. 71 Issue 11 Pg. 962-8 (Jun 01 2012) ISSN: 1873-2402 [Electronic] United States
• PMID: 22480663 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Chemical References

• Antimetabolites
• Receptors, N-Methyl-D-Aspartate
• Cycloserine

Topics

• Adult
• Antimetabolites (therapeutic use)
• Combined Modality Therapy
• Cycloserine (therapeutic use)
• Double-Blind Method
• Female
• Humans
• Implosive Therapy (methods)
• Male
• Middle Aged
• Receptors, N-Methyl-D-Aspartate (agonists)
• Stress Disorders, Post-Traumatic (therapy)
• Treatment Outcome