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d-Cycloserine Augmentation of Cognitive Behavioral Therapy for Anxiety Disorders: an Update

  • Anxiety Disorders (A Pelissolo, Section Editor)
  • Published:
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Abstract

Although cognitive behavioral therapy (CBT) is a generally effective treatment for treating anxiety disorders, there is clearly still room for further improvements. Recent advances in neuroscience of extinction learning led to novel clinical strategies to augment exposure-based treatments with d-cycloserine (DCS), a partial agonist at the glycine recognition site of the glutamatergic N-methyl-d-aspartate receptor. This review provides an update on the current knowledge of DCS as an augmentation strategy of CBT for anxiety disorders. The adequacy of the CBT to be augmented, the dose of DCS, and the timing and duration of augmentation efforts all appear to be important moderating variables. Moreover, there is evidence that DCS may also augment fear memory reconsolidation if the fear level remains high after the exposure. Future studies need to examine whether DCS can augment CBT when administered after exposure in order to develop a tailored administration strategy to maximize its clinical utility.

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Acknowledgments

Dr. Hofmann’s work is supported by NIH grant R01AT007257 and R34MH099311. Dr. Smits’s work is supported by NIH grants R34MH099318, R34DA031038, R01DA027533, and R34DA034658.

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Conflict of Interest

Stefan G. Hofmann serves on the Advisory Board of Otsuka America Pharmaceutical, Inc., and receives financial compensation for his participation as an advisor.

Jasper A. Smits declares no conflict of interest.

Michael W. Otto receives payment as consultant from ProPhase, MicroTransponder, and Concert Pharmaceuticals and royalties for use of the SIGH-A.

Mark H. Pollack is on the advisory boards and provides consultation for Concert Pharmaceuticals, Edgemont Pharmaceuticals, Ironwood Pharmaceuticals, Palo Alto Health Sciences, Project Plus. He receives equity from Doyen Medical, Medavante, Mensante Corporation, Mindsite, Targia Pharmaceuticals and royalty/patent payment for the SIGH-A, SAFER interviews.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Psychological and Brain Sciences, Boston University, 648 Beacon Street, 6th Floor, Boston, MA, 02215-2002, USA

    Stefan G. Hofmann & Michael W. Otto

  2. Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA

    Mark H. Pollack

  3. Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, TX, USA

    Jasper A. Smits

Authors
  1. Stefan G. Hofmann
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  2. Michael W. Otto
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  3. Mark H. Pollack
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  4. Jasper A. Smits
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Corresponding author

Correspondence to Stefan G. Hofmann.

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This article is part of the Topical Collection on Anxiety Disorders

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Hofmann, S.G., Otto, M.W., Pollack, M.H. et al. d-Cycloserine Augmentation of Cognitive Behavioral Therapy for Anxiety Disorders: an Update. Curr Psychiatry Rep 17, 532 (2015). https://doi.org/10.1007/s11920-014-0532-2

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  • DOI: https://doi.org/10.1007/s11920-014-0532-2

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