• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN SA Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Study Suggests DCS Not Effective in PTSD Treatment

Study Suggests DCS Not Effective in PTSD Treatment

September 1, 2012
Glen Spielmans, PhD
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Glen Spielmans, PhD Associate professor of psychology, Metropolitan State University, St. Paul, MN Glen Spielmans, PhD, has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Subject:
PTSD

Short Description:
Study Suggests DCS Not Effective in PTSD Treatment

Background:

Exposure therapy is a cognitive behavioral strategy that serves as a core treatment for anxiety disorders. Animal and human studies alike have supported the use of D-cycloserine (DCS) as an agent to augment the effectiveness of exposure therapy in specific phobia, social phobia, panic disorder, and obsessive-compulsive disorder. D-cycloserine, also known as Seromycin, is an antituberculosis drug that also acts as a partial agonist of the NMDA receptor. It is hypothesized that stimulation of NMDA receptors helps enable “extinction learning,” or the remodeling of pathways in the amygdala to decrease conditioned fear responses.

A new study, however, finds that DCS does not improve treatment responses in patients undergoing prolonged exposure therapy for posttraumatic stress disorder, or PTSD. Sixty-seven patients with PTSD underwent a standardized program of up to 10 sessions of prolonged exposure therapy. Half (33) received 50 mg of D-cycloserine one hour before each exposure session while the others received placebo. Most of the patients completing the trial reported a decrease in symptoms as measured by the Post traumatic Stress Symptom Scale (PSS-SR). Patients taking DCS had higher response rates (odds ratio for response was 2.83, 95%CI=1.05–7.61), but statistical tests showed that this could not be attributed to DCS, probably because of differences in baseline severity between groups.

Patients were allowed to continue their other medications during the study, and the events underlying each patient’s PTSD varied from sexual assault to traffic accidents. Also, nearly one-third of the patients dropped out of the study. These factors might explain the lack of an obvious benefit of DCS. A subgroup analysis, however, showed that those patients who required the full 10 sessions of therapy were significantly more likely to benefit from DCS: mean PSS-SR scores decreased by 43.9% in those receiving DCS, vs only 7.8% in those receiving placebo (de Kleine RA et al, Biol Psychiatry 2012;71:962–968).

TCPR's Take:
DCS does not appear to enhance treatment response in patients undergoing exposure therapy for PTSD. There was some suggestion that it may help patients with serious symptoms who require longer treatment, compared with those who complete treatment earlier. But previous, smaller studies on DCS in exposure therapy for other anxiety disorders showed effects in just a few sessions, and another recent paper shows that patients undergoing short-term exposure for war-related PTSD actually did worse with DCS (Litz BT et al, J Psychiatr Res 2012:online ahead of print). Whether DCS has a place in treating PTSD is still not clear, but these studies suggest that it probably contributes little to a good, evidence-based modality like exposure therapy.
General Psychiatry
KEYWORDS ptsd research_updates
Ccpr octnovdec2020 qa1 headshot spielmans 150x150
Glen Spielmans, PhD

CBT Moderately Effective in Improving Quality of Life for Anxiety Disorders

More from this author
www.thecarlatreport.com
Issue Date: September 1, 2012
SUBSCRIBE NOW
Table Of Contents
Helping Patients with Eating Disorders
Study Looks at Use of TMS to Treat Depression
Parasite Infection Possible Precursor to Suicidal Behavior
Study Suggests DCS Not Effective in PTSD Treatment
Eating Disorder Treatment Challenges
Eating Disorder Treatment Resources
Eating Disorders as Addictions
DOWNLOAD NOW
Featured Book
  • MFB6eCover.jpg

    Medication Fact Book for Psychiatric Practice, Sixth Edition (2022)

    Guidance, clinical pearls, and bottom-line assessments covering the medications you use in your...
    READ MORE
Featured Video
  • therapist_canstockphoto9201097.jpg
    General Psychiatry

    Using SAMe In Clinical Practice with Garrett Rossi, MD

    Read More
Featured Podcast
  • canstockphoto84222831.jpg
    General Psychiatry

    The Adderall Shortage

    Adderall is in short supply, and the backlog is having a domino effect on other stimulants. Find out why, and how long it will last.

    Listen now
Recommended
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png

About

  • About Us
  • CME Center
  • FAQ
  • Contact Us

Shop Online

  • Newsletters
  • Multimedia Subscriptions
  • Books
  • eBooks
  • ABPN Self-Assessment Courses

Newsletters

  • The Carlat Psychiatry Report
  • The Carlat Child Psychiatry Report
  • The Carlat Addiction Treatment Report
  • The Carlat Hospital Psychiatry Report
  • The Carlat Geriatric Psychiatry Report

Contact

info@thecarlatreport.com

866-348-9279

PO Box 626, Newburyport MA 01950

Follow Us

Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

© 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved.