Journal
BIOLOGICAL PSYCHIATRY
Volume 71, Issue 11, Pages 962-968Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.biopsych.2012.02.033
Keywords
Cognitive behavioral therapy; cognitive enhancers; D-cycloserine; posttraumatic stress disorder; prolonged exposure; treatment efficacy
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Funding
- Stichting Achmea Slachtoffer en Samenleving
- Vereniging tot Christelijke Verzorging van Geestes-en Zenuwzieken
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Background: Posttraumatic stress disorder (PTSD) is a complex and debilitating anxiety disorder, and, although prolonged exposure therapy has been proven effective, many patients remain symptomatic after treatment. In other anxiety disorders, the supplementary use of D-cycloserine (DCS), a partial agonist at the glutamatergic N-methyl-D-aspartate receptor, showed promise in enhancing treatment effects. We examined whether augmentation of prolonged exposure therapy for PTSD with DCS enhances treatment efficacy. Methods: In a randomized, double-blind, placebo-controlled trial we administered 50 mg DCS or placebo 1 hour before each exposure session to 67 mixed trauma patients, recruited from regular referrals, with a primary PTSD diagnosis satisfying DSM-IV criteria. Results: Although DCS did not enhance overall treatment effects, the participants having received DCS did show a stronger treatment response. Exploratory session-by-session analyses revealed that DCS yielded higher symptom reduction in those participants that had more severe pretreatment PTSD and needed longer treatment. Conclusions: The present study found preliminary support for the augmentation of exposure therapy with DCS, specifically for patients with more severe PTSD needing longer treatment.
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