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Commentary| Volume 71, ISSUE 11, P932-934, June 01, 2012

Enhancing Prolonged Exposure Therapy for Posttraumatic Stress Disorder with D-Cycloserine: Further Support for Treatments That Promote Experience-Dependent Neuroplasticity

  • John H. Krystal
    Correspondence
    Address correspondence to John H. Krystal, M.D., Clinical Neuroscience Division, Veterans Affairs National Center for PTSD, Veterans Affairs Connecticut Healthcare Center, 950 Campbell Ave, West Haven, Connecticut 06516
    Affiliations
    Clinical Neuroscience Division, Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare Center, West Haven, Connecticut

    Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
    Search for articles by this author
      Posttraumatic 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 (
      • Kulka R.
      • Schlenger W.
      • Fairbank J.
      • Hough R.
      • Jordan B.
      • Marmar C.
      Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study.
      ,
      • Joffe C.
      • Brodaty H.
      • Luscombe G.
      • Ehrlich F.
      The Sydney Holocaust study: posttraumatic stress disorder and other psychosocial morbidity in an aged community sample.
      ). The very persistence of the impact of what can be a single life experience suggests that traumatization profoundly engages neuroplasticity mechanisms. In addition, compromised neuroplasticity may be a factor preventing individuals with PTSD from benefiting from available social supports and from psychotherapies and pharmacotherapies for PTSD.
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      References

        • Kulka R.
        • Schlenger W.
        • Fairbank J.
        • Hough R.
        • Jordan B.
        • Marmar C.
        Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study.
        Brunner Mazel, New York1990
        • Joffe C.
        • Brodaty H.
        • Luscombe G.
        • Ehrlich F.
        The Sydney Holocaust study: posttraumatic stress disorder and other psychosocial morbidity in an aged community sample.
        J Trauma Stress. 2003; 16: 39-47
        • de Kleine R.A.
        • Hendriks G.-J.
        • Kusters W.J.C.
        • Broekman T.G.
        • van Minnen A.
        A randomized placebo-controlled trial of D-cycloserine to enhance exposure therapy for posttraumatic stress disorder.
        Biol Psychiatry. 2012; 71: 962-968
        • Heresco-Levy U.
        • Kremer I.
        • Javitt D.C.
        • Goichman R.
        • Reshef A.
        • Blanaru M.
        • et al.
        Pilot-controlled trial of D-cycloserine for the treatment of post-traumatic stress disorder.
        Int J Neuropsychopharmacol. 2002; 5: 301-307
        • Davis M.
        • Ressler K.
        • Rothbaum B.O.
        • Richardson R.
        Effects of D-cycloserine on extinction: translation from preclinical to clinical work.
        Biol Psychiatry. 2006; 60: 369-375
        • Norberg M.M.
        • Krystal J.H.
        • Tolin D.F.
        A meta-analysis of D-cycloserine and the facilitation of fear extinction and exposure therapy.
        Biol Psychiatry. 2008; 63: 1118-1126
        • Santa Ana E.J.
        • Rounsaville B.J.
        • Frankforter T.L.
        • Nich C.
        • Babuscio T.
        • Poling J.
        • et al.
        D-cycloserine attenuates reactivity to smoking cues in nicotine dependent smokers: a pilot investigation.
        Drug Alcohol Depend. 2009; 104: 220-227
        • D'Souza D.C.
        • Gil R.
        • Cassello K.
        • Morrissey K.
        • Abi-Saab D.
        • White J.
        • et al.
        IV glycine and oral D-cycloserine effects on plasma and CSF amino acids in healthy humans.
        Biol Psychiatry. 2000; 47: 450-462
        • Sah P.
        • Westbrook R.F.
        Behavioural neuroscience: the circuit of fear.
        Nature. 2008; 454: 589-590
        • Mao S.C.
        • Lin H.C.
        • Gean P.W.
        Augmentation of fear extinction by D-cycloserine is blocked by proteasome inhibitors.
        Neuropsychopharmacology. 2008; 33: 3085-3095

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