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.
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.
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.
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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Published online: April 05, 2012
Accepted: February 22, 2012
Received in revised form: February 7, 2012
Received: July 29, 2011
© 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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- Enhancing Prolonged Exposure Therapy for Posttraumatic Stress Disorder with D-Cycloserine: Further Support for Treatments That Promote Experience-Dependent NeuroplasticityBiological PsychiatryVol. 71Issue 11
- PreviewPosttraumatic stress disorder (PTSD) is a common, distressing, and debilitating consequence of the experience of extremely stressful life events, exemplified by combat, sexual assault, torture, or natural disasters. Although the majority of people exposed to these extreme events recover within days to months, long-term follow-up of Vietnam Veterans and survivors of the Nazi Death Camps indicate that for many traumatized people, symptoms persist for decades, perhaps for the rest of their lives (1,2).