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A Randomized Placebo-Controlled Trial of d-Cycloserine to Enhance Exposure Therapy for Posttraumatic Stress Disorder

  • Rianne A. de Kleine
    Correspondence
    Address correspondence to Rianne de Kleine, M.Sc., Center for Anxiety Disorders Overwaal, Tarweweg 2, 6543 AM Nijmegen, The Netherlands
    Affiliations
    Radboud University Nijmegen, Behavioural Science Institute, NijCare, The Netherlands

    Center for Anxiety Disorders Overwaal, Nijmegen, The Netherlands
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  • Gert-Jan Hendriks
    Affiliations
    Radboud University Nijmegen, Behavioural Science Institute, NijCare, The Netherlands

    Center for Anxiety Disorders Overwaal, Nijmegen, The Netherlands

    Outpatient Mental Health Clinic Hendriks and Roosenboom, Arnhem, The Netherlands

    Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
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  • Wendy J.C. Kusters
    Affiliations
    Radboud University Nijmegen, Behavioural Science Institute, NijCare, The Netherlands

    Outpatient Mental Health Clinic Hendriks and Roosenboom, Arnhem, The Netherlands
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  • Theo G. Broekman
    Affiliations
    Bureau Bêta, Nijmegen, The Netherlands
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  • Agnes van Minnen
    Affiliations
    Radboud University Nijmegen, Behavioural Science Institute, NijCare, The Netherlands

    Center for Anxiety Disorders Overwaal, Nijmegen, The Netherlands
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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.

      Key Words

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