D-Cycloserine as an augmentation strategy with cognitive-behavioral therapy for social anxiety disorder.
D-Cycloserine as an augmentation strategy with cognitive-behavioral therapy for social anxiety disorder.
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DOI：
10.1176/appi.ajp.2013.12070974
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发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Pollack MH
中科院分区：
文献类型：
--
作者：
Hofmann SG;Smits JA;Rosenfield D;Simon N;Otto MW;Meuret AE;Marques L;Fang A;Tart C;Pollack MH
目的测试 d-环丝氨酸（谷氨酸 N-甲基-D-天冬氨酸受体的部分激动剂）是否能够增强和加速患有广泛性社交焦虑症的未用药成人的全面认知行为治疗 (CBT) 的全程。 2007 年 9 月至 2011 年 12 月期间，波士顿大学、马萨诸塞州总医院和南卫理公会大学对 169 名患有广泛性社交焦虑症的未接受药物治疗的成年人进行了一项随机安慰剂对照疗效研究； 144 人完成治疗，131 人完成后续评估。患者被随机分配在 5 次暴露疗程前 1 小时接受 50 毫克 d-环丝氨酸或安慰剂，这是 12 疗程认知行为组治疗的一部分。缓解和缓解状态是在基线、整个治疗过程、治疗后以及由不了解治疗情况的评估者进行的 1、3 和 6 个月随访评估时确定的。 D-环丝氨酸增强和安慰剂增强的 CBT 与治疗后相似的完成率（87% 和 82%）、缓解率（79.3% 和 73.3%）以及缓解率（34.5% 和 24.4%）相关，并且在随访中基本保持不变。尽管在 12 周的治疗阶段，与安慰剂相比，d-环丝氨酸的症状严重程度改善率和缓解率提高了 24-33%，但各组在缓解率和缓解率方面没有差异。 D-环丝氨酸并不能增强社交焦虑症综合 CBT 的整个疗程。 http://www.ClinicalTrials.gov，ID# NCT00633984，http://www.clinicalTrials.gov/ct2/show/NCT00633984
To test whether d-cycloserine, a partial agonist at the glutamatergic N-methyl-D-aspartate receptor, augments and accelerates a full course of comprehensive cognitive behavioral therapy (CBT) in medication-free adults with generalized social anxiety disorder. A randomized placebo-controlled efficacy-study conducted at Boston University, Massachusetts General Hospital, and Southern Methodist University between 9/2007 and 12/2011 of 169 medication-free adults with generalized social anxiety disorder; 144 completed treatment, and 131 completed the follow-up assessments. Patients were randomized to receive 50 mg of d-cycloserine or placebo 1 hour before each of 5 exposure sessions that were part of a 12-session cognitive behavioral group treatment. Response and remission status was determined at baseline, throughout treatment, post-treatment, and at 1, 3, and 6-month follow-up assessments rated by assessors who were blind to treatment condition. D-cycloserine-augmented and placebo-augmented CBT were associated with similar completion rates (87% and 82%), response rates (79.3% and 73.3%), and remission rates (34.5% and 24.4%) at post-treatment that were largely maintained at follow-up. Although d-cycloserine was associated with a 24–33% faster rate of improvement in symptom severity and remission rates relative to placebo during the 12-week treatment phase, the groups did not differ in response and remission rates. D-cycloserine did not augment a full course of comprehensive CBT for social anxiety disorder. http://www.ClinicalTrials.gov, ID# NCT00633984, http://www.clinicaltrials.gov/ct2/show/NCT00633984
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