Work

d -Cycloserine Augmentation of Behavioral Therapy for the Treatment of Anxiety Disorders

Year: 2012

Type: article

Study designs: Systematic Review, Meta-Analysis

Abstract: OBJECTIVE: To determine the efficacy of D-cycloserine augmentation of behavioral therapy for the treatment of anxiety disorders. DATA SOURCES AND STUDY SELECTION: Using the search terms D-cycloserine AND anxiety disorders (MeSH), PubMed (1965-June 2011), PsycINFO, and Scopus were searched for randomized, double-blind, placebo-controlled trials of D-cycloserine augmentation of behavioral therapy for the treatment of anxiety disorders. Anxiety disorders were defined as any disorder categorized as such in DSM-IV-TR. DATA EXTRACTION: A random-effects model was used to calculate the standardized mean difference of change in anxiety rating scale scores with D-cycloserine augmentation compared to placebo, which was the primary outcome measure. Subgroup analysis and meta-regression were used to examine the effects of D-cycloserine dosage and timing (relative to exposure therapy), diagnostic indication, number of therapy sessions, and trial methodological quality on D-cycloserine efficacy. RESULTS: Meta-analysis of 9 trials involving 273 subjects demonstrated a significant benefit from D-cycloserine augmentation (standardized mean difference = 0.46 [95% CI, 0.15 to 0.77], z = 2.89, P = .004). There was no evidence of publication bias, but a moderate, nonsignificant degree of heterogeneity between trials (I2 = 36%, Q = 12.6, df = 8, P = .12) was found. Secondary analyses yielded no significant findings. CONCLUSIONS: D-Cycloserine appears to be an effective augmentation agent that enhances the effects of behavioral therapy in the treatment of anxiety disorders. In contrast to a previous meta-analysis that examined D-cycloserine's effects in both animals and humans, we found no evidence of an effect of dose number, dose timing, or dosage of D-cycloserine on reported efficacy in the ranges studied.

Source: The Journal of Clinical Psychiatry

DOI: 10.4088/jcp.11r07356

Authors: Allyson Bontempo, Kaitlyn E. Panza, Michael H. Bloch

Institution: Yale University

Language: English

Topic: Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Subfield: Experimental and Cognitive Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: green