Effects of D-cycloserine on extinction: Translation from preclinical to clinical work
Effects of D-cycloserine on extinction: Translation from preclinical to clinical work
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DOI：
10.1016/j.biopsych.2006.03.084
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发表时间：
2006-08-15
影响因子：
10.6
通讯作者：
Richardson, Rick
中科院分区：
文献类型：
--
作者：
Davis, Michael;Ressler, Kerry;Richardson, Rick
苯二氮卓类药物或血清素再摄取抑制剂与行为疗法相结合来治疗许多焦虑症通常只能取得有限的效果。在本文中，我们建议药物治疗的目的不是治疗焦虑症状，而是旨在改善暴露疗法中的学习，实际上可能会提高暴露疗法的有效性。这一想法基于动物研究，表明在暴露于恐惧暗示之前或之后不久给予N-甲基-D-天冬氨酸（NMDA）部分激动剂D-环丝氨酸（DCS）可促进恐惧消退，减少通常在消退训练后紧接着压力时出现的恐惧回归，并导致普遍消退，其中DCS与暴露于一种可怕提示相结合会导致消退 与先前与同一厌恶事件配对的另一个线索相比，这些发现表明 DCS 可能有助于基于暴露的心理治疗，这一点在一项小型临床研究中得到验证，表明 DCS 有助于在控制良好的虚拟现实环境中针对高度恐惧的暴露治疗。
Administration of benzodiazepines or serotonin reuptake inhibitors in combination with behavior therapy for the treatment of many anxiety disorders has generally lead to only modest gains. In this article we suggest that pharmacotherapy aimed not at treating the symptoms of anxiety but instead aimed at improving the learning that takes place in exposure therapy might actually improve the effectiveness of exposure therapy. This idea was based on animal work showing that the partial N-methyl-D-aspartate (NMDA) agonist D-cycloserine (DCS) facilitated extinction of fear when given either before or shortly after exposure to fearful cues, reduced return of fear that is normally seen when extinction training is followed by stress, and led to generalized extinction, where DCS given in combination with exposure to one fearful cue led to extinction to another cue previously paired with the same aversive event, These finding suggested that DCS might facilitate exposure-based psychotherapy, which was verified in a small clinical study showing that DCS facilitated exposure therapy for fear of heights in a well-controlled virtual reality environment.