Purpose/background: D-cycloserine (DCS) is a partial N-methyl-D-aspartate receptor agonist that potentially augments response to exposure therapy in anxiety disorders by enhancing extinction learning. This randomized, double-blinded, placebo-controlled augmentation trial examined (1) the effectiveness of adding 125 mg of DCS to exposure therapy (before or directly after the first 6 treatment sessions) in patients with panic disorder with agoraphobia and (2) the effectiveness of DCS augmentation preceding exposure relative to DCS augmentation directly postexposure.
Methods/procedures: Fifty-seven patients were allocated to 1 of 3 medication conditions (placebo and pre-exposure and postexposure DCS) as an addition to 6 exposure sessions within a 12-session exposure and response prevention protocol. The primary outcome measure was the mean score on the "alone" subscale of the Mobility Inventory (MI).
Findings/results: No differences were found in treatment outcome between DCS and placebo, administered either pre-exposure or postexposure therapy, although at 3-month follow-up, the DCS postexposure group compared with DCS pre-exposure, exhibited greater symptom reduction on the MI-alone subscale. Ancillary analyses in specific subgroups (responders vs nonresponders, early vs late responders, severely vs mildly affected patients) did not reveal any between-group DCS versus placebo differences. Finally, the study did not find an effect of DCS relative to placebo to be specific for successful exposure sessions.
Implications/conclusions: This study does not find an effect of augmentation with DCS in patients with severe panic disorder and agoraphobia administered either pretreatment or directly posttreatment sessions. Moreover, no preferential effects are revealed in specific subgroups nor in successful exposure sessions. Yet, a small effect of DCS administration postexposure therapy cannot be ruled out, given the relatively small sample size of this study.
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http://dx.doi.org/10.1097/JCP.0000000000000757 | DOI Listing |
Neuro Endocrinol Lett
December 2024
Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, Czech Republic.
Introduction: PAdverse Childhood Experiences (ACEs) are associated with an increased risk of mental health issues in general, but their relationship with panic disorder (PD) and obsessive-compulsive disorder (OCD) has received less attention compared to borderline personality disorder (BPD). Dissociative experiences are significant predictors of increased symptoms, reduced treatment adherence, and poor prognosis in several psychiatric conditions, including PD, OCD, and BPD; still, their impact remains underexplored. This part of the study focuses on the overall efficiency of psychotherapeutic programs on treatment-resistant patients diagnosed with PD, OCD, and BPD (or combined), as well as the relationship between ACEs, dissociation rates, and treatment results.
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December 2024
Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, Czech Republic.
Introduction: Panic disorder (PD), obsessive-compulsive disorder (OCD), and borderline personality disorder (BPD) are associated with various psychosocial factors that may influence their onset and psychopathology. Dissociation encompasses a wide range of manifestations, from benign experiences to severe mental health issues. Research comparing childhood trauma and dissociation, general psychopathology, and the onset of the disorder among patients with PD, OCD, and BPD has not yet been published.
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December 2024
Rogers Behavioral Health, Research Center, Oconomowoc WI & Philadelphia PA, 34700 Valley Rd, Oconomowoc, WI, 53066, USA. Electronic address:
The presentation of avoidant/restrictive food intake disorder (ARFID) characterized by fear of aversive consequences of eating (fear-ARFID) has both phenomenological and mechanistic similarities to panic disorder. In this narrative review, we propose a shared model of the pathogenesis of the two disorders, centered on interoceptive sensitivity as the key maintenance mechanism. We review the evidence that fear-ARFID, which involves restrictive eating motivated by a desire to avoid aversive events (e.
View Article and Find Full Text PDFJ Mol Histol
December 2024
Faculty of Engineering, Department of Chemistry, Istanbul University- Cerrahpaşa, Avcilar, Istanbul, Türkiye.
Sodium valproate- a salt of valproic acid (VPA), is an anticonvulsant used in the treatment of epilepsy and a range of psychiatric conditions that include panic attacks, anxiety, post-traumatic stress, migraine and bipolar disorder etc. VPA can cause direct damage to many tissues due to accumulation of toxic metabolites. Nowadays, phytochemicals are amongst the best options for the treatment of diseases.
View Article and Find Full Text PDFCureus
November 2024
Department of Traditional Medicine, Toho University, Tokyo, JPN.
Fibromyalgia (FM) is a common chronic pain with no established treatment. Acupuncture is an expected treatment for FM though a diagnosis of FM tends to be delayed, and the advantage is still unclear in early-phase intervention with acupuncture treatment for FM. A 51-year-old woman with panic disorder presented with a four-month history of whole-body pain and was diagnosed with FM.
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