D-Cycloserine Augmentation of Cognitive Behavioral Therapy for Anxiety Disorders: an Update
D-Cycloserine Augmentation of Cognitive Behavioral Therapy for Anxiety Disorders: an Update
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DOI：
10.1007/s11920-014-0532-2
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发表时间：
2015-01-01
影响因子：
6.7
通讯作者：
Smits, Jasper A.
中科院分区：
文献类型：
--
作者：
Hofmann, Stefan G.;Otto, Michael W.;Smits, Jasper A.
尽管认知行为疗法（CBT）是治疗焦虑症的一种普遍有效的治疗方法，但显然仍有进一步改进的空间。最近在神经科学中的进展导致了新的临床策略，以增加基于d-cycloserine（DCS）的治疗，DCS是一种在谷氨酸能N-甲基-D-天冬氨酸受体的甘氨酸识别位点的部分激动剂。本文综述了DCS作为CBT治疗焦虑症的增强策略的最新知识。CBT的适当性，DCS的剂量，以及增强努力的时间和持续时间似乎都是重要的调节变量。此外，有证据表明，如果暴露后恐惧水平仍然很高，DCS也可能增强恐惧记忆的再巩固。未来的研究需要检查DCS是否可以在暴露后给药时增强CBT，以制定量身定制的给药策略，以最大限度地发挥其临床效用。
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.