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Am J Psychiatry. 2013 Jul;170(7):751-8. doi: 10.1176/appi.ajp.2013.12070974.

D-Cycloserine as an augmentation strategy with cognitive-behavioral therapy for social anxiety disorder.

Author information

1
Department of Psychology, Boston University, Boston, USA. shofmann@bu.edu

Abstract

OBJECTIVE:

The authors examined 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 adults with generalized social anxiety disorder.

METHOD:

This was a multisite randomized placebo-controlled efficacy study with 169 medication-free adults with generalized social anxiety disorder, of whom 144 completed the 12-week treatment and 131 completed the three follow-up assessments. Patients were randomly assigned to receive 50 mg of D-cycloserine or placebo 1 hour before each of five exposure sessions that were part of a 12-session cognitive-behavioral group treatment. Response and remission status was determined at baseline, throughout treatment, at end of treatment, and at 1-, 3-, and 6-month follow-up assessments by assessors who were blind to treatment condition.

RESULTS:

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 the posttreatment assessment; response and remission rates were largely maintained at the follow-up assessments. Although D-cycloserine was associated with a 24%-33% faster rate of improvement in symptom severity and remission rates relative to placebo during the treatment phase, the groups did not differ in response and remission rates.

CONCLUSIONS:

D-Cycloserine did not augment a full course of comprehensive CBT for social anxiety disorder.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00633984.

PMID:
23599046
PMCID:
PMC4058999
DOI:
10.1176/appi.ajp.2013.12070974
[Indexed for MEDLINE]
Free PMC Article

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