Pharmacological enhancement of behavioral therapy: focus on posttraumatic stress disorder

Curr Top Behav Neurosci. 2010:2:279-99. doi: 10.1007/7854_2009_10.

Abstract

Improved efficacy in the treatment of posttraumatic stress disorder (PTSD) and other anxiety disorders is urgently needed. Traditional anxiety treatments of hypnosis and psychodynamic therapy may be of some help, but uncontrolled studies lead to inconclusive results on the efficacy of these treatment techniques. There is a larger literature supporting the efficacy of cognitive-behavioral procedures with PTSD, including prolonged exposure therapy, eye movement desensitization and reprocessing, and anxiety management techniques. The cutting-edge technology of virtual reality-based exposure therapy for PTSD is particularly exciting. To further build on effective psychosocial treatments, current pharmacological augmentation approaches to emotional learning are being combined with psychotherapy. In particular, D-cycloserine, a partial NMDA agonist, has shown to be effective in facilitating the exposure/extinction therapy to improve the efficacy of treating anxiety disorders, and may guide the way for new pharmacological enhancements of behavioral therapy.

Publication types

  • Review

MeSH terms

  • Animals
  • Anxiety Disorders / therapy
  • Cognitive Behavioral Therapy* / methods
  • Combined Modality Therapy / methods
  • Cycloserine / therapeutic use*
  • Desensitization, Psychologic* / methods
  • Extinction, Psychological*
  • Eye Movement Desensitization Reprocessing
  • Humans
  • Hypnosis*
  • Implosive Therapy
  • Obsessive-Compulsive Disorder / therapy
  • Panic Disorder / therapy
  • Phobic Disorders / therapy
  • Receptors, N-Methyl-D-Aspartate / agonists
  • Stress Disorders, Post-Traumatic / drug therapy
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy*
  • Treatment Outcome

Substances

  • Receptors, N-Methyl-D-Aspartate
  • Cycloserine