title: D-Cycloserine as an augmentation strategy with cognitive-behavioral therapy for social anxiety disorder.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: Department of Psychology, Boston University, Boston, USA. shofmann@bu.edu
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Hofmann
authors.forename: Jasper A J
authors.initials: JA
authors.lastname: Smits
authors.forename: David
authors.initials: D
authors.lastname: Rosenfield
authors.forename: Naomi
authors.initials: N
authors.lastname: Simon
authors.forename: Michael W
authors.initials: MW
authors.lastname: Otto
authors.forename: Alicia E
authors.initials: AE
authors.lastname: Meuret
authors.forename: Luana
authors.initials: L
authors.lastname: Marques
authors.forename: Angela
authors.initials: A
authors.lastname: Fang
authors.forename: Candyce
authors.initials: C
authors.lastname: Tart
authors.forename: Mark H
authors.initials: MH
authors.lastname: Pollack
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003523:Cycloserine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D010698:Phobic Disorders / Q000188:drug therapy / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D016194:Receptors, N-Methyl-D-Aspartate / Q000819:agonists*; D012074:Remission Induction
chemical_list: D016194:Receptors, N-Methyl-D-Aspartate; D003523:Cycloserine