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Cited by 326Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and ApplicationsSchizophrenia research and treatment

A Randomized Controlled Trial of D-Cycloserine Enhancement of Exposure Therapy for Social Anxiety Disorder

Guastella, Adam J., Richardson, Rick, Lovibond, Peter F., Rapee, Ronald M., Gaston, Jonathan E., Mitchell, Philip, Dadds, Mark R.·2008·Biological Psychiatry
DOI 10.1016/j.biopsych.2007.11.011
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Abstract

Background Pilot research has suggested that D-cycloserine (DCS) enhances treatment outcomes for anxiety disorders when employed as an adjunct to exposure therapy (ET). The aim of this study was to determine whether 50 mg of DCS enhances ET for social anxiety disorder (SAD) according to a comprehensive set of symptom and life impairment measures.Methods In a randomized double-blind placebo-controlled trial, we administered 50 mg of DCS or placebo in combination with ET to 56 participants who met primary diagnosis for SAD.Results Participants administered DCS reported greater improvement on measures of symptom severity, dysfunctional cognitions, and life-impairment from SAD in comparison with placebo-treated participants. Effect sizes were mostly in the medium range. Results also indicated that the amount of adaptive learning about one's ability to give speeches in front of an audience interacted with DCS to enhance treatment outcome.Conclusions This study shows that the administration of DCS before ET enhances treatment outcomes for SAD. Results also provide the first preliminary evidence to suggest that DCS moderates the relationship between a reduction in negative appraisals about one's speech performance and improvement in overall SAD symptoms.

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  • Early studies on D-cycloserine administration during exposure in vivo for SAD have yielded promising results.

    “For SAD, early studies on D-cycloserine administration during exposure in vivo have yielded promising results (Guastella et al., 2008; Hofmann et al., 2006; Rodrigues et al., 2014)”

    From Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder (2024) · cites this paper as Guastella et al., 2008

  • DCS combined with imaginal or virtual reality exposure therapy has been shown to reduce length of treatment for some anxiety disorders, including acrophobia, social phobia, and panic disorder.

    “Recently, DCS combined with imaginal or virtual reality exposure (VRE) therapy has been shown to reduce length of treatment for some anxiety disorders, including acrophobia (Ressler et al, 2004), social phobia (Guastella et al, 2008; Hofmann et al, 2006), and panic disorder (Otto et al, 2010), which, like PTSD, include learned avoidance and cued emotional distress as salient symptoms.”

    From D-cycloserine augmentation of exposure therapy for post-traumatic stress disorder: a pilot randomized clinical trial (2014) · cites this paper as Guastella et al, 2008

  • In humans, DCS administration can facilitate the loss of fear resulting from exposure that causes incomplete fear loss in controls.

    “In humans, DCS administration can likewise facilitate the loss of fear resulting from exposure that causes incomplete fear loss in controls (acrophobia: Ressler, Rothbaum, Tannenbaum, Anderson, Graap, Zimand, Hodges, & Davis, 2004; social phobia: Guastella, Richardson, Lovibond, Rapee, Gaston, Mitchell, & Dadds, 2008; Hofmann, Meuret, Smits, Simon, Pollack, Eisenmenger, Shiekh, & Otto, 2006;”

    From D-cycloserine facilitates context-specific fear extinction learning (2008) · cites this paper as Guastella, Richardson, Lovibond, Rapee, Gaston, Mitchell, & Dadds, 2008

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Authors
Guastella, A. J., Richardson, R., Lovibond, P. F., Rapee, R. M., Gaston, J. E., Mitchell, P., & Dadds, M. R.
Affiliations
  • UNSW Sydney (AU)
  • Macquarie University (AU)
Corresponding author
Guastella, Adam J.
ORCID
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2008-03
Volume
63
Issue
6
Pages
544-549
ISSN
0006-3223 (ISSN-L)
DOI
10.1016/j.biopsych.2007.11.011
OpenAlex
W2028445187
Semantic Scholar
e41984c470918166ac39c6aec20bd21dfc842860
Cited by
326
References
30
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 9 · 2020: 5 · 2019: 9 · 2018: 13 · 2017: 23 · 2016: 12 · 2015: 15 · 2014: 41 · 2013: 32 · 2012: 31
FWCI
53.98
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Health and Medical Research Council (350963)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
D-cycloserine, social anxiety disorder, exposure therapy, adjunctive pharmacotherapy, treatment enhancement, speech performance, dysfunctional cognitions, negative appraisals
MeSH terms
Adolescent, Adult, Combined Modality Therapy, Cycloserine, Desensitization, Psychologic, Double-Blind Method, Fear, Female, Humans, Male, Middle Aged, New South Wales, Phobic Disorders, Premedication, Speech

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