Enhancement of Psychosocial Treatment With D-Cycloserine: Models, Moderators, and Future Directions.

Abstract:

:Advances in the understanding of the neurobiology of fear extinction have resulted in the development of d-cycloserine (DCS), a partial glutamatergic N-methyl-D-aspartate agonist, as an augmentation strategy for exposure treatment. We review a decade of research that has focused on the efficacy of DCS for augmenting the mechanisms (e.g., fear extinction) and outcome of exposure treatment across the anxiety disorders. Following a series of small-scale studies offering strong support for this clinical application, more recent larger-scale studies have yielded mixed results, with some showing weak or no effects. We discuss possible explanations for the mixed findings, pointing to both patient and session (i.e., learning experiences) characteristics as possible moderators of efficacy, and offer directions for future research in this area. We also review recent studies that have aimed to extend the work on DCS augmentation of exposure therapy for the anxiety disorders to DCS enhancement of learning-based interventions for addiction, anorexia nervosa, schizophrenia, and depression. Here, we attend to both DCS effects on facilitating therapeutic outcomes and additional therapeutic mechanisms beyond fear extinction (e.g., appetitive extinction, hippocampal-dependent learning).

journal_name

Biol Psychiatry

journal_title

Biological psychiatry

authors

Otto MW,Kredlow MA,Smits JAJ,Hofmann SG,Tolin DF,de Kleine RA,van Minnen A,Evins AE,Pollack MH

doi

10.1016/j.biopsych.2015.09.007

subject

Has Abstract

pub_date

2016-08-15 00:00:00

pages

274-283

issue

4

eissn

0006-3223

issn

1873-2402

pii

S0006-3223(15)00767-2

journal_volume

80

pub_type

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