D-Cycloserine as an augmentation strategy with cognitive-behavioral therapy for
social anxiety disorder.
Author(s): Hofmann SG(1), Smits JA, Rosenfield D, Simon N, Otto MW, Meuret AE, Marques L,
Fang A, Tart C, Pollack MH.
Affiliation(s): Author information:
(1)Department of Psychology, Boston University, Boston, USA. shofmann@bu.edu
Publication date & source: 2013, Am J Psychiatry. , 170(7):751-8
OBJECTIVE: The authors examined whether D-cycloserine, a partial agonist at the
glutamatergic N-methyl-d-aspartate receptor, augments and accelerates a full
course of comprehensive cognitive-behavioral therapy (CBT) in adults with
generalized social anxiety disorder.
METHOD: This was a multisite randomized placebo-controlled efficacy study with
169 medication-free adults with generalized social anxiety disorder, of whom 144
completed the 12-week treatment and 131 completed the three follow-up
assessments. Patients were randomly assigned to receive 50 mg of D-cycloserine or
placebo 1 hour before each of five exposure sessions that were part of a
12-session cognitive-behavioral group treatment. Response and remission status
was determined at baseline, throughout treatment, at end of treatment, and at 1-,
3-, and 6-month follow-up assessments by assessors who were blind to treatment
condition.
RESULTS: D-Cycloserine-augmented and placebo-augmented CBT were associated with
similar completion rates (87% and 82%), response rates (79.3% and 73.3%), and
remission rates (34.5% and 24.4%) at the posttreatment assessment; response and
remission rates were largely maintained at the follow-up assessments. Although
D-cycloserine was associated with a 24%-33% faster rate of improvement in symptom
severity and remission rates relative to placebo during the treatment phase, the
groups did not differ in response and remission rates.
CONCLUSIONS: D-Cycloserine did not augment a full course of comprehensive CBT for
social anxiety disorder.
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