Clinical perspectives on the combination of D-cycloserine and cognitive-behavioral therapy for the treatment of anxiety disorders.
In a particular success for translational research agendas, characterization of the neuronal circuits underlying fear extinction, and basic research in animal extinction paradigms, has led to intervention studies examining the use of D-cycloserine (DCS) to enhance therapeutic learning from exposure-based cognitive-behavioral therapy (CBT). In this article, we review these intervention studies, and discuss DCS augmentation of CBT relative to more traditional combination-treatment strategies in the treatment of anxiety disorders. We offer an accounting, based on evidence for internal context effects, of current limitations in the combination of antidepressant or benzodiazepine medications with CBT and discuss the advantages of isolated-dosing strategies with DCS relative to these limitations. This strategy is contrasted with the chronic-dosing applications of DCS for schizophrenia and Alzheimer's disease, and future directions for isolated-dosing strategies are discussed.
Otto
Michael W
MW
Center for Anxiety and Related Disorders, Department of Psychology, Boston University, Boston, MA 02215, USA.
Basden
Shawnee L
SL
Leyro
Teresa M
TM
McHugh
R Kathryn
RK
Hofmann
Stefan G
SG
D000818:Animals; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D001921:Brain / Q000187:drug effects; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003523:Cycloserine / Q000008:administration & dosage* / Q000009:adverse effects; D003887:Desensitization, Psychologic; D004195:Disease Models, Animal; D005239:Fear / Q000187:drug effects; D006801:Humans; D016032:Randomized Controlled Trials as Topic
D003523:Cycloserine