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A meta-analysis of D-cycloserine and the facilitation of fear extinction and exposure therapy.
Biol Psychiatry. 2008 Jun 15; 63(12):1118-26.BP

Abstract

BACKGROUND

Translational research suggests that D-cycloserine (DCS), a partial N-methyl-D-aspartate (NMDA) receptor agonist, might facilitate fear extinction and exposure therapy by either enhancing NMDA receptor function during extinction or by reducing NMDA receptor function during fear memory consolidation. This article provides a quantitative review of DCS-augmented fear extinction and exposure therapy literature.

METHODS

English-language journal articles that examined DCS augmented with fear extinction or exposure therapy were identified through public databases from June 1998 through September 2007, through references of originally identified articles and contact with DCS investigators. Data were extracted for study author, title, and year; trial design; type of subject (animal vs. human; clinical vs. nonclinical); sample size, DCS dose, and timing in relation to extinction/exposure procedures; dependent variable; group means and SDs at post-extinction/exposure; and follow-up outcome.

RESULTS

D-cycloserine enhances fear extinction/exposure therapy in both animals and anxiety-disordered humans. Gains generally were maintained at follow-up, although some lessening of efficacy was noted. D-cycloserine was more effective when administered a limited number of times and when given immediately before or after extinction training/exposure therapy.

CONCLUSIONS

This meta-analysis suggests that DCS is a useful target for translational research on augmenting exposure-based treatment via compounds that impact neuroplasticity. D-cycloserine 's major contribution to exposure-based therapy might be to increase its speed or efficiency, because the effects of DCS seem to decrease over repeated sessions. This information might guide translational researchers in discovering more selective and/or effective agents that effectively enhance (or reduce) NMDA receptor function.

Authors+Show Affiliations

Institute of Living, New Haven, CT 06106, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

18313643

Citation

Norberg, Melissa M., et al. "A Meta-analysis of D-cycloserine and the Facilitation of Fear Extinction and Exposure Therapy." Biological Psychiatry, vol. 63, no. 12, 2008, pp. 1118-26.
Norberg MM, Krystal JH, Tolin DF. A meta-analysis of D-cycloserine and the facilitation of fear extinction and exposure therapy. Biol Psychiatry. 2008;63(12):1118-26.
Norberg, M. M., Krystal, J. H., & Tolin, D. F. (2008). A meta-analysis of D-cycloserine and the facilitation of fear extinction and exposure therapy. Biological Psychiatry, 63(12), 1118-26. https://doi.org/10.1016/j.biopsych.2008.01.012
Norberg MM, Krystal JH, Tolin DF. A Meta-analysis of D-cycloserine and the Facilitation of Fear Extinction and Exposure Therapy. Biol Psychiatry. 2008 Jun 15;63(12):1118-26. PubMed PMID: 18313643.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A meta-analysis of D-cycloserine and the facilitation of fear extinction and exposure therapy. AU - Norberg,Melissa M, AU - Krystal,John H, AU - Tolin,David F, Y1 - 2008/03/07/ PY - 2007/11/21/received PY - 2008/01/14/revised PY - 2008/01/14/accepted PY - 2008/3/4/pubmed PY - 2008/8/16/medline PY - 2008/3/4/entrez SP - 1118 EP - 26 JF - Biological psychiatry JO - Biol Psychiatry VL - 63 IS - 12 N2 - BACKGROUND: Translational research suggests that D-cycloserine (DCS), a partial N-methyl-D-aspartate (NMDA) receptor agonist, might facilitate fear extinction and exposure therapy by either enhancing NMDA receptor function during extinction or by reducing NMDA receptor function during fear memory consolidation. This article provides a quantitative review of DCS-augmented fear extinction and exposure therapy literature. METHODS: English-language journal articles that examined DCS augmented with fear extinction or exposure therapy were identified through public databases from June 1998 through September 2007, through references of originally identified articles and contact with DCS investigators. Data were extracted for study author, title, and year; trial design; type of subject (animal vs. human; clinical vs. nonclinical); sample size, DCS dose, and timing in relation to extinction/exposure procedures; dependent variable; group means and SDs at post-extinction/exposure; and follow-up outcome. RESULTS: D-cycloserine enhances fear extinction/exposure therapy in both animals and anxiety-disordered humans. Gains generally were maintained at follow-up, although some lessening of efficacy was noted. D-cycloserine was more effective when administered a limited number of times and when given immediately before or after extinction training/exposure therapy. CONCLUSIONS: This meta-analysis suggests that DCS is a useful target for translational research on augmenting exposure-based treatment via compounds that impact neuroplasticity. D-cycloserine 's major contribution to exposure-based therapy might be to increase its speed or efficiency, because the effects of DCS seem to decrease over repeated sessions. This information might guide translational researchers in discovering more selective and/or effective agents that effectively enhance (or reduce) NMDA receptor function. SN - 1873-2402 UR - https://www.unboundmedicine.com/medline/citation/18313643/A_meta_analysis_of_D_cycloserine_and_the_facilitation_of_fear_extinction_and_exposure_therapy_ DB - PRIME DP - Unbound Medicine ER -