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Dr. Bob is Robert Hsiung, MD,
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Posted by ed_uk on December 31, 2004, at 14:34:41
Hello fellow anxiety sufferers!
As you will know Specific Phobias are often treated by exposing the sufferer to the thing that they fear until they (hopefully) get used to it and don't fear it anymore. Unfortunately, this doesn't always work :-(
Cycloserine (an antibiotic which is occasionally used to treat tuberculosis/TB) has recently been shown to have a possible role in the treatment of certain types of anxiety. Cycloserine (also called D-cycloserine, DCS and Seromycin) is reported to enhance the effectivesness of behavioural exposure therapy in the treatment of Specific Phobias. Cycloserine is believed to act as a partial agonist at the glycine regulatory site on the NMDA receptor.
Has anyone on p-babble ever taken cycloserine???
Have a look at this study...........
Arch Gen Psychiatry. 2004 Nov;61(11):1136-44.Cognitive enhancers as adjuncts to psychotherapy: use of D-cycloserine in phobic individuals to facilitate extinction of fear.
BACKGROUND: Traditional pharmacological approaches to treating psychiatric disorders focus on correcting presumed biochemical abnormalities. However, some disorders, particularly the anxiety-related disorders exemplified by specific phobia, have an emotional learning component to them that can be facilitated with psychotherapy. OBJECTIVE: To determine whether D-cycloserine (DCS), a partial agonist at the N-methyl-d-aspartate receptor that has previously been shown to improve extinction of fear in rodents, will also improve extinction of fear in human phobic patients undergoing behavioral exposure therapy. DESIGN: Randomized, double-blind, placebo-controlled trial examining DCS vs placebo treatment in combination with a precisely controlled exposure paradigm. SETTING: Participants were recruited from the general community to a research clinic. PARTICIPANTS: Twenty-eight subjects with acrophobia diagnosed by the Structured Clinical Interview for DSM-IV were enrolled. INTERVENTIONS: After we obtained pretreatment measures of fear, subjects were treated with 2 sessions of behavioral exposure therapy using virtual reality exposure to heights within a virtual glass elevator. Single doses of placebo or DCS were taken prior to each of the 2 sessions of virtual reality exposure therapy. Subjects, therapists, and assessors were blind to the treatment condition. Subjects returned at 1 week and 3 months posttreatment for measures to determine the presence and severity of acrophobia symptoms. MAIN OUTCOME MEASURES: Included were measures of acrophobia within the virtual environment, measures of acrophobia in the real world, and general measures of overall improvement. An objective measure of fear, electrodermal skin fluctuation, was also included during the virtual exposure to heights. Symptoms were assessed by self-report and by independent assessors at approximately 1 week and 3 months posttreatment. RESULTS: Exposure therapy combined with DCS resulted in significantly larger reductions of acrophobia symptoms on all main outcome measures. Subjects receiving DCS had significantly more improvement compared with subjects receiving placebo within the virtual environment (1 week after treatment, P</=.001; 3 months later, P</=.05). Subjects receiving DCS also showed significantly greater decreases in posttreatment skin conductance fluctuations during the virtual exposure (P</=.05). Additionally, subjects receiving DCS had significantly greater improvement compared with subjects receiving placebo on general measures of real-world acrophobia symptoms (acrophobia avoidance [P</=.02], acrophobia anxiety [P</=.01], attitudes toward heights [P</=.04], clinical global improvement [P</=.01], and number of self-exposures to real-world heights [P</=.01]); the improvement was evident early in treatment and was maintained at 3 months. CONCLUSION: These pilot data provide initial support for the use of acute dosing of DCS as an adjunct to exposure-based psychotherapy to accelerate the associative learning processes that contribute to correcting psychopathology.
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When used at high doses for the treatment of tuberculosis, cycloserine can cause serious neurological side effects such as 'anxiety, confusion, disorientation, depression, psychoses possibly with suicidal tendencies, aggression, irritability, and paranoia. Vertigo, headache, drowsiness, speech difficulties, tremor, paresis, hyperreflexia, dysarthria, paraesthesia, coma, and convulsions may also occur.'
It is important to bear in mind that the neurological side effects of cycloserine are dose-related. Also, only a few doses of cycloserine are given in the treatment of phobias. In the treatment of TB, high daily doses are needed over a long period of time.
Ed.
Posted by ed_uk on January 1, 2005, at 17:04:35
In reply to Phobias and Cycloserine:Extinguishing the Fear, posted by ed_uk on December 31, 2004, at 14:34:41
Surely there must be at least a few phobics out there.......
Posted by Phillipa on January 1, 2005, at 17:32:02
In reply to Re: Phobias and Cycloserine:Extinguishing the Fear, posted by ed_uk on January 1, 2005, at 17:04:35
Of course there are! Hi Ed! I have many phobias and am developing more daily As far as desensitizing yourself to them by venturing out into the situation, this hasn't worked for me. I think controlling the anxiety that leads to them helps. When benzos worked, and before
AD's, I didn't have any. Phillipa XO
Posted by ed_uk on January 1, 2005, at 17:44:42
In reply to Re: Phobias and Cycloserine:Extinguishing the Fear » ed_uk, posted by Phillipa on January 1, 2005, at 17:32:02
Hello!
I'm glad you replied! I know what you mean about desensitization, it can make things worse :-(
Ed xx
Posted by coral on January 3, 2005, at 9:49:21
In reply to Phobias and Cycloserine:Extinguishing the Fear, posted by ed_uk on December 31, 2004, at 14:34:41
I, too, would be very interested to hear of someone's results using cycloserine
This is the end of the thread.
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