Augmentation of exposure therapy with post-session administration of
D-cycloserine.
Author(s): Tart CD(1), Handelsman PR, Deboer LB, Rosenfield D, Pollack MH, Hofmann SG,
Powers MB, Otto MW, Smits JA.
Affiliation(s): Author information:
(1)Department of Psychology, Southern Methodist University, USA.
candycetart@gmail.com
Publication date & source: 2013, J Psychiatr Res. , 47(2):168-74
BACKGROUND: Pre-session administration of d-cycloserine (DCS) has been found to
augment exposure therapy outcomes in a variety of anxiety disorders. To be able
to enhance learning only for successful exposure sessions, it would be beneficial
to have the option of administering DCS after rather than before the session, a
strategy encouraged by pre-clinical work. We believe the present study is the
first published report on the efficacy of post-session administration of DCS in
humans.
METHOD: Adults (N = 29) with a DSM-IV diagnosis of acrophobia were randomized to
receive two sessions of virtual reality exposure therapy (VRE) in combination
with placebo or 50 mg of DCS. Instead of administering the pill prior to each of
the sessions, as has been done in extant work, we administered the pill
immediately following each session. Measures of acrophobia severity were
collected at baseline, at each treatment session, 1-week post-treatment, and at
1-month follow-up.
RESULTS: Mixed-effects repeated-measures ANOVAs and GLMMs revealed significant
improvement in all outcome measures over time, but no between-group differences
were observed. At post-treatment, 63.5% of patients in the placebo condition vs.
60.0% of those in the DCS condition were in remission. At 1-month follow up,
63.4% of those in the placebo condition vs. 66.6% of those in the DCS condition
were in remission.
CONCLUSIONS: These findings do not support the application of post-session DCS
administration for augmenting the efficacy of exposure-based treatments. Possible
reasons for these findings are discussed.
TRIAL REGISTRY: The Trial is registered at ClinicalTrials.gov (NCT01102803).
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