title: A randomized controlled trial of the effect of D-cycloserine on exposure therapy for spider fear.
abstract: Previous research [Hofmann SG, Meuret AE, Smits JA, Simon NM, Pollack MH, Eisenmenger K, et al. Augmentation of exposure therapy for social anxiety disorder with D-cycloserine. Archives of General Psychiatry 2006;63:298-304; Ressler KJ, Rothbaum BO, Tannenbaum L, Anderson P, Graap K, Zimand E, et al. Cognitive enhancers as adjuncts to psychotherapy: use of d-cycloserine in phobic individuals to facilitate extinction of fear. Archives of General Psychiatry 2004;61:1136-44] suggests that d-cycloserine (DCS) facilitates the reduction of clinical fear in humans. We used a well established intervention to evaluate the effectiveness of administering DCS as an adjunct to exposure therapy in a heightened, but sub-clinical, fear population. Over two studies, 100 spider-fearful participants were allocated to DCS or placebo before treatment and were assessed at pre-, immediate post-, and 3.5 weeks post-treatment. Significant treatment effects and return of fear was observed at follow-up, particularly in non-treatment contexts; however, both studies failed to demonstrate any enhancing effects of DCS (50 or 500 mg). DCS did not enhance the reduction of spider fears or the generalisation of treatment of a single session of exposure-based therapy. These results suggest that DCS may not enhance loss of non-clinical levels of fear in human populations.
authors.affiliation: School of Psychology, University of New South Wales, Kensington, Sydney, NSW 2052, Australia. a.guastella@unsw.edu.au
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Guastella
authors.forename: Mark R
authors.initials: MR
authors.lastname: Dadds
authors.forename: Peter F
authors.initials: PF
authors.lastname: Lovibond
authors.forename: Philip
authors.initials: P
authors.lastname: Mitchell
authors.forename: Rick
authors.initials: R
authors.lastname: Richardson
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003523:Cycloserine / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005108:Extinction, Psychological; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016202:N-Methylaspartate / Q000096:biosynthesis*; D010698:Phobic Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D010775:Photic Stimulation / Q000379:methods*; D013112:Spiders
chemical_list: D016202:N-Methylaspartate; D003523:Cycloserine