Augmentation of (imaginal) exposure therapy with D-cycloserine for patients with post-traumatic stress disorder (PTSD)
background The augmentation of D-cycloserine to exposure therapy is a promising approach to improve treatment results of exposure-based treatments in patients with anxiety disorders. It was proven effective in social phobia and ocd, but thus far studies in ptsd are lacking.
aim To give a short overview of D-cycloserine effects in anxiety disorders. In addition, to present the results of effectivity of D-cycloserine in addition to exposure treatment sessions in ptsd patients, who suffered mixed traumas.
method This study was a randomised and placebo double-blind controlled trial. After inclusion, patients were randomised in two treatment conditions; 1. Exposure plus D-Cycloserine and 2. Exposure plus placebo. Both groups received an effective therapy program for ptsd, exposure therapy. Both groups received 8-12 sessions of imaginal exposure at the outpatient clinic. An hour before the imaginal exposure sessions, the experimental group used D-cycloserine 50 mg. The control group used a placebo an hour before the exposure sessions.
results We included 55 patients with ptsd. At this moment we still have to analyze the data. We expect for the D-cycloserine group 1. A greater and faster decrease of ptsd symptoms and related psychopathology (general anxiety and depression) from pretreatment to posttreatment, measured with both self-report measures and clinically rated instruments. And 2. Better endstate functioning at posttreatment. More specifically, less patients will fulfill ptsd diagnostic criteria at posttreatment as established with standardised clinical interviews and more patients will be able to work at a pretrauma level and function socially well.
conclusion The results will be discussed in the light of new developments in anxiety disorder treatments, and exposure therapies.