Does D-cycloserine enhance exposure therapy for anxiety disorders in humans? A meta-analysis.

The treatment of anxiety is on the edge of a new era of combinations of pharmacologic and psychosocial interventions. A new wave of translational research has focused on the use of pharmacological agents as psychotherapy adjuvants using neurobiological insights into the mechanism of the action of ce...

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Main Authors: Helga Rodrigues, Ivan Figueira, Alessandra Lopes, Raquel Gonçalves, Mauro Vitor Mendlowicz, Evandro Silva Freire Coutinho, Paula Ventura
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0093519
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author Helga Rodrigues
Ivan Figueira
Alessandra Lopes
Raquel Gonçalves
Mauro Vitor Mendlowicz
Evandro Silva Freire Coutinho
Paula Ventura
author_facet Helga Rodrigues
Ivan Figueira
Alessandra Lopes
Raquel Gonçalves
Mauro Vitor Mendlowicz
Evandro Silva Freire Coutinho
Paula Ventura
author_sort Helga Rodrigues
collection DOAJ
description The treatment of anxiety is on the edge of a new era of combinations of pharmacologic and psychosocial interventions. A new wave of translational research has focused on the use of pharmacological agents as psychotherapy adjuvants using neurobiological insights into the mechanism of the action of certain psychological treatments such as exposure therapy. Recently, d-cycloserine (DCS) an antibiotic used to treat tuberculosis has been applied to enhance exposure-based treatment for anxiety and has proved to be a promising, but as yet unproven intervention. The present study aimed to evaluate the efficacy of DCS in the enhancement of exposure therapy in anxiety disorders. A systematic review/meta-analysis was conducted. Electronic searches were conducted in the databases ISI-Web of Science, Pubmed and PsycINFO. We included only randomized, double-blind, placebo-controlled trials with humans, focusing on the role of DCS in enhancing the action of exposure therapy for anxiety disorders. We identified 328 references, 13 studies were included in our final sample: 4 on obsessive-compulsive disorder, 2 on panic disorder, 2 on social anxiety disorder, 2 on posttraumatic stress disorder, one on acrophobia, and 2 on snake phobia. The results of the present meta-analysis show that DCS enhances exposure therapy in the treatment of anxiety disorders (Cohen d =  -0.34; CI: -0.54 to -0.14), facilitating the specific process of extinction of fear. DCS seems to be effective when administered at a time close to the exposure therapy, at low doses and a limited number of times. DCS emerges as a potential new therapeutic approach for patients with refractory anxiety disorders that are unresponsive to the conventional treatments available. When administered correctly, DCS is a promising strategy for augmentation of CBT and could reduce health care costs, drop-out rates and bring faster relief to patients.
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spelling doaj-art-a729c05d20894f35950c19503a9741a42025-08-20T03:31:34ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0197e9351910.1371/journal.pone.0093519Does D-cycloserine enhance exposure therapy for anxiety disorders in humans? A meta-analysis.Helga RodriguesIvan FigueiraAlessandra LopesRaquel GonçalvesMauro Vitor MendlowiczEvandro Silva Freire CoutinhoPaula VenturaThe treatment of anxiety is on the edge of a new era of combinations of pharmacologic and psychosocial interventions. A new wave of translational research has focused on the use of pharmacological agents as psychotherapy adjuvants using neurobiological insights into the mechanism of the action of certain psychological treatments such as exposure therapy. Recently, d-cycloserine (DCS) an antibiotic used to treat tuberculosis has been applied to enhance exposure-based treatment for anxiety and has proved to be a promising, but as yet unproven intervention. The present study aimed to evaluate the efficacy of DCS in the enhancement of exposure therapy in anxiety disorders. A systematic review/meta-analysis was conducted. Electronic searches were conducted in the databases ISI-Web of Science, Pubmed and PsycINFO. We included only randomized, double-blind, placebo-controlled trials with humans, focusing on the role of DCS in enhancing the action of exposure therapy for anxiety disorders. We identified 328 references, 13 studies were included in our final sample: 4 on obsessive-compulsive disorder, 2 on panic disorder, 2 on social anxiety disorder, 2 on posttraumatic stress disorder, one on acrophobia, and 2 on snake phobia. The results of the present meta-analysis show that DCS enhances exposure therapy in the treatment of anxiety disorders (Cohen d =  -0.34; CI: -0.54 to -0.14), facilitating the specific process of extinction of fear. DCS seems to be effective when administered at a time close to the exposure therapy, at low doses and a limited number of times. DCS emerges as a potential new therapeutic approach for patients with refractory anxiety disorders that are unresponsive to the conventional treatments available. When administered correctly, DCS is a promising strategy for augmentation of CBT and could reduce health care costs, drop-out rates and bring faster relief to patients.https://doi.org/10.1371/journal.pone.0093519
spellingShingle Helga Rodrigues
Ivan Figueira
Alessandra Lopes
Raquel Gonçalves
Mauro Vitor Mendlowicz
Evandro Silva Freire Coutinho
Paula Ventura
Does D-cycloserine enhance exposure therapy for anxiety disorders in humans? A meta-analysis.
PLoS ONE
title Does D-cycloserine enhance exposure therapy for anxiety disorders in humans? A meta-analysis.
title_full Does D-cycloserine enhance exposure therapy for anxiety disorders in humans? A meta-analysis.
title_fullStr Does D-cycloserine enhance exposure therapy for anxiety disorders in humans? A meta-analysis.
title_full_unstemmed Does D-cycloserine enhance exposure therapy for anxiety disorders in humans? A meta-analysis.
title_short Does D-cycloserine enhance exposure therapy for anxiety disorders in humans? A meta-analysis.
title_sort does d cycloserine enhance exposure therapy for anxiety disorders in humans a meta analysis
url https://doi.org/10.1371/journal.pone.0093519
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