title: NMDA receptors and fear extinction: implications for cognitive behavioral therapy.
abstract: Based primarily on studies that employ Pavlovian fear conditioning, extinction of conditioned fear has been found to be mediated by N-methyi-D-aspartate (NMDA) receptors in the amygdala and medial prefrontal cortex. This led to the discovery that an NMDA partial agonist, D-cycloserine, could facilitate fear extinction when given systemically or locally into the amygdala. Because many forms of cognitive behavioral therapy depend on fear extinction, this led to the successful use of D-cycloserine as an adjunct to psychotherapy in patients with so-called simple phobias (fear of heights), social phobia, obsessive-compulsive behavior, and panic disorder. Data in support of these conclusions are reviewed, along with some of the possible limitations of D-cycloserine as an adjunct to psychotherapy.
authors.affiliation: Emory University, Yerkes National Primate Center and the Center for Behavioral Neuroscience, Atlanta, Georgia, USA. mdavis4@emory.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Davis
mesh_terms: D000679:Amygdala / Q000187:drug effects / Q000502:physiology; D000818:Animals; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000503:physiopathology*; D015928:Cognitive Behavioral Therapy; D003523:Cycloserine / Q000627:therapeutic use*; D005108:Extinction, Psychological / Q000187:drug effects / Q000502:physiology; D005239:Fear / Q000187:drug effects* / Q000502:physiology*; D006801:Humans; D016194:Receptors, N-Methyl-D-Aspartate / Q000819:agonists / Q000502:physiology*
chemical_list: D016194:Receptors, N-Methyl-D-Aspartate; D003523:Cycloserine