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Augmentation of Psychotherapy with D-Cycloserine in Patients with Anxiety Disorders

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NeuroPsychopharmacotherapy

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Abstract

Cognitive-behavioral therapy, including exposure therapy, as well as certain psychopharmacotherapies are considered effective first-line treatments for anxiety disorders. However, not all patients respond sufficiently to these treatment options. D-4-amino-3-isoxazolidone, commonly known as D-cycloserine, is an antibiotic that has been increasingly studied for its effects as a partial agonist of the N-methyl-D-aspartate receptor, a receptor in the brain that is thought to be relevant for synaptic plasticity. Experimental studies in animals indicate that D-cycloserine may enhance learning and memory processes. As learning represents a central goal of many psychotherapy methods, the supposed effect of D-cycloserine on learning may be utilized to improve psychotherapy outcomes. In recent years, a growing body of evidence from randomized controlled trials suggests that small doses of D-cycloserine may be used to augment exposure therapy for anxiety disorders, increasing the efficacy of exposure therapy by a small-to-moderate amount. The size of this augmentation effect appears to depend on moderating factors such as the number of D-cycloserine doses, timing of administration, or the patient’s severity of illness. Additional randomized controlled trials are needed to identify optimal administration procedures for enhancing exposure therapy outcomes in both adults and children. Further studies assessing the usefulness of D-cycloserine in the treatment of other mental disorders as well as its possible effects on the outcome of other psychotherapeutic methods would also be desirable.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Berlin, Germany

    Leopold Maria Lautenbacher, Lena Pyrkosch, Lea Mascarell Maricic & Andreas Ströhle

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  1. Leopold Maria Lautenbacher
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  2. Lena Pyrkosch
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  3. Lea Mascarell Maricic
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  4. Andreas Ströhle
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Correspondence to Lena Pyrkosch .

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Editors and Affiliations

  1. Dept Psychiatry , Psychosomatics & Psychotherapy, University of Würzburg, Medical School Clinical Neurochemistry, Würzburg, Germany

    Peter Riederer

  2. Inst für Psychologische Medizin, Haag, Bayern, Germany

    Gerd Laux

  3. Fujita Health University School Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Bayern, Germany

    Christian Riederer

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  1. Centre for Addiction and Mental Health; Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Stefan Kloiber

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Lautenbacher, L.M., Pyrkosch, L., Maricic, L.M., Ströhle, A. (2021). Augmentation of Psychotherapy with D-Cycloserine in Patients with Anxiety Disorders. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_446-1

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