Archival ReportEfficacy of D-Cycloserine for Enhancing Response to Cognitive-Behavior Therapy for Panic Disorder
Section snippets
Participant Selection
Identical study protocols were approved by the Institutional Review Board at each of three study sites. Participants were first screened by phone, followed by in-person diagnostic and severity evaluations with masters or doctoral level clinicians. After a complete description of the study, participants provided written informed consent. Participants then underwent diagnostic evaluation using the Structured Clinical Interview for DSM-IV (SCID-IV) (21) and severity rating using the Clinician
PDSS
The multivariate ANCOVA of PDSS scores at posttreatment and follow-up, controlling for pretreatment PDSS scores (mean 13.8 ± 3.3), yielded a significant main effect of group in favor of DCS, with a large effect size [F(1,24) = 7.34, p = .012, η2p = .234, d = 1.11]. There was no significant main effect of time [F(1,24) = .02, p = .901, η2p = .001], nor was there a significant group by time interaction [F(1,24) = .093, p = .763, η2p = .004], indicating that the stronger response for DCS did not
Discussion
We found that administration of single doses of DCS, 1 hour before each of three exposure sessions within a five-session protocol, significantly enhanced the efficacy of brief CBT for panic disorder. In addition to significant differences in continuous outcome measures, at posttreatment, 77% of patients who had received DCS, compared with only 33% of patients who had received placebo augmentation, met criteria for clinically significant change. The treatment gains of the DCS group were
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NMDA receptor-mediated processing in inferior frontal gyrus facilitates acquisition and extinction learning and strengthens renewal
2022, Neurobiology of Learning and MemoryCitation Excerpt :In particular the partial NMDAR agonist d-cycloserine (DCS) showed enhancing effects in fear extinction,(e.g. Ledgerwood et al., 2003). This finding led to DCS now being widely used in psychotherapy of phobias, social anxiety and panic disorder, in combination with exposure treatments (Otto et al., 2010; Ressler et al., 2004; Smits et al., 2013). Also in our previous studies with healthy human participants in a non-fear-related predictive learning task, NMDAR modulation before extinction learning was shown to influence extinction learning while concurrently altering BOLD activation in hippocampal and prefrontal regions.
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