PTSD psychotherapy is enhanced with D-cycloserine

June 4, 2012

Posttraumatic stress disorder (PTSD) is among the most common, distressing, and disabling medical consequences of combat or other extremely stressful life events. The first-line treatment for PTSD is exposure therapy, a type of behavioral therapy where patients confront their fears in a safe environment. Although it is an effective treatment, many patients still experience symptoms after treatment and there is a relatively high drop-out rate.

In an effort to improve existing treatments, a new study appearing in Biological Psychiatry this week has tested a novel hypothesis about the treatment of PTSD derived from prior work in animal models and other . They examined whether the impact of psychotherapy could be enhanced by administering D-cycloserine (DCS), a drug that does not directly treat the symptoms of PTSD, but rather promotes neuroplasticity, i.e., makes better able to remodel themselves in the context of experience.

To test this, researchers recruited individuals with PTSD, all of whom received up to 10 weekly sessions of . They were randomized to receive doses of either DCS or placebo before each session, but did not know which they were receiving. The severity of their symptoms was assessed before and after treatment.

All patients experienced a reduction in symptoms due to the exposure therapy, regardless of whether they had received DCS augmentation or placebo. However, DCS did enhance the effects of exposure therapy in a specific subgroup of patients. Those who had more severe PTSD prior to treatment and needed longer treatment had a greater reduction in symptoms when they received DCS, compared to those who received placebo.

"Our study showed that some PTSD patients respond well and fast to exposure and for them, there seems no need to augment the therapy. In contrast, those patients with severe PTSD symptoms and who fail to respond to exposure sessions may benefit from augmentation with DCS," explained first author Dr. Rianne de Kleine. "It seems that DCS is beneficial for exactly those patients we aimed for: the more severe patients who do not respond to first-line treatment."

"This approach may have important implications for the treatment of PTSD. Two decades of brain research suggests that severe psychological stress causes atrophy of some of the fine connections in the brain and reductions in the volume of brain regions involved in emotion and memory. Thus, individuals with PTSD may have deficits in neuroplasticity that get in the way of effective treatment," commented Dr. John Krystal, Editor of . "D-cycloserine may reduce this deficit in neuroplasticity and increase the response to psychotherapy, in this case a approach that involves exposing people to reminders and memories of the trauma."

The authors conclude that additional work is warranted to explore whether this combination can become an effective intervention to treat the symptoms of PTSD.

Explore further: Use of antipsychotics for reducing military-related chronic PTSD symptoms does not appear effective

More information: The article is "A Randomized Placebo-Controlled Trial of D-Cycloserine to Enhance Exposure Therapy for Posttraumatic Stress Disorder" by Rianne A. de Kleine, Gert-Jan Hendriks, Wendy J.C. Kusters, Theo G. Broekman, and Agnes van Minnen (doi: 10.1016/j.biopsych.2012.02.033). The article appears in Biological Psychiatry, Volume 71, Issue 11 (June 1, 2012)

Related Stories

Use of antipsychotics for reducing military-related chronic PTSD symptoms does not appear effective

August 2, 2011
Patients with military-related, chronic posttraumatic stress disorder (PTSD) and symptoms that were not improved with use of an antidepressant medication did not experience a reduction in PTSD symptoms with use of the antipsychotic ...

Certain therapies appear beneficial in reducing PTSD symptoms in some trauma survivors

October 3, 2011
Prolonged exposure therapy, cognitive therapy, and delayed prolonged exposure therapy, appear to reduce posttraumatic stress disorder symptoms in patients who have experienced a recent traumatic event, according to a report ...

Cancer patients suffer PTSD years after diagnosis

October 14, 2011
(Medical Xpress) -- Even after surviving cancer treatment, a new study published in the Journal of Clinical Oncology reports that many cancer patients suffer from post-traumatic stress disorder, or PTSD, that can worsen as ...

Memory-enhancing drug may improve exposure therapy for PTSD patients

November 3, 2011
A memory-enhancing drug may improve the speed and effectiveness of prolonged exposure therapy for post-traumatic stress disorder (PTSD) patients, according to a new pilot study by psychologists at The University of Texas ...

Recommended for you

Probing how Americans think about mental life

October 20, 2017
When Stanford researchers asked people to think about the sensations and emotions of inanimate or non-human entities, they got a glimpse into how those people think about mental life.

Itsy bitsy spider: Fear of spiders and snakes is deeply embedded in us

October 19, 2017
Snakes and spiders evoke fear and disgust in many people, even in developed countries where hardly anybody comes into contact with them. Until now, there has been debate about whether this aversion is innate or learnt. Scientists ...

Inflamed support cells appear to contribute to some kinds of autism

October 18, 2017
Modeling the interplay between neurons and astrocytes derived from children with Autism Spectrum Disorder (ASD), researchers at University of California San Diego School of Medicine, with colleagues in Brazil, say innate ...

Study suggests psychedelic drugs could reduce criminal behavior

October 18, 2017
Classic psychedelics such as psilocybin (often called magic mushrooms), LSD and mescaline (found in peyote) are associated with a decreased likelihood of antisocial criminal behavior, according to new research from investigators ...

Taking probiotics may reduce postnatal depression

October 18, 2017
Researchers from the University of Auckland and Otago have found evidence that a probiotic given in pregnancy can help prevent or treat symptoms of postnatal depression and anxiety.

Schizophrenia disrupts the brain's entire communication system, researchers say

October 17, 2017
Some 40 years since CT scans first revealed abnormalities in the brains of schizophrenia patients, international scientists say the disorder is a systemic disruption to the brain's entire communication system.

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

DanielHaszard
not rated yet Jun 05, 2012
PTSD treatment for Veterans found ineffective.

Eli Lilly made $65 billion on the Zyprexa franchise.Lilly was fined $1.4 billion for Zyprexa fraud!
The atypical antipsychotics (Zyprexa,Risperdal,Seroquel) are like a 'synthetic' Thorazine,only they cost ten times more than the old fashioned typical antipsychotics.
These newer generation drugs still pack their list of side effects like diabetes for the user.All these drugs work as so called 'major tranquilizers'.This can be a contradiction with PTSD suffers as we are hyper vigilant and feel uncomfortable with a drug that puts you to sleep and makes you sluggish.
That's why drugs like Zyprexa don't work for PTSD survivors like myself.
-Daniel Haszard FMI http://www.zyprexa-victims.com

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.