D-Cycloserine: A Promising Phobia Treatment

Tuberculosis Medication Shown to Help Reduce Fear

D-cycloserine can be used to treat a fear of heights.
D-cycloserine can be used to treat a fear of heights.. s5iztok/Getty Images

Originally approved by the Food and Drug Administration for the treatment of tuberculosis, D-cycloserine (Seromycin) may be the next line of defense in phobia treatment. The antibiotic has been found to aid in the treatment of a variety of simple phobias, including the fear of spiders (arachnophobia) and a fear of heights (acrophobia). The drug is not helpful as a sole treatment, however, and works as an adjunct to exposure therapy in patients with phobias.

Repeated clinical trials have demonstrated that patients with acrophobia (fear of heights) who receive exposure therapy, and who also took D-cycloserine, learn to override their fears more quickly than those who took a placebo. Exposure therapy, which is often used in the treatment of anxiety disorders, targets learned behaviors that people engage in (most often the avoidance) in response to situations or thoughts and memories that are viewed as frightening or anxiety-provoking.

How Does D-Cycloserine Work?

D-cycloserine is thought to affect certain receptors, namely NMDA receptors, in the amygdala portion of the brain (a part of your brain that is associated with fear). It does not directly treat the phobia. Instead, the drug appears to stimulate the area of the brain that is responsible for unlearning fear responses.

In other words, it works to "speed up" or increase the response to exposure therapy.

This, in turn, may minimize the frustration often felt during early treatment and thereby prevent a person from stopping therapy prematurely. Although research is still underway, clinical trials have found few side effects when using D-cycloserine in the treatment of anxiety disorders. D-cycloserine has also been studied for its effectiveness in the treatment of Alzheimer's disease, schizophrenia, OCD, PTSD and other anxiety disorders.

If you think D-Cycloserine could work for you, talk to your health care provider. Together you can weigh the risks and benefits of using this medication, alongside exposure therapy, in the treatment of your specific phobia or anxiety disorder.

Sources:

Rodrigues H, Figueira I, Lopes A, Gonçalves R, Mendlowicz MV, Coutinho ESF, et al. Does D-Cycloserine Enhance Exposure Therapy for Anxiety Disorders in Humans? A Meta-Analysis. PLoS ONE. July 2014.

Ressler MD, PhD, Kerry, Rothbaum PhD, Barbara O., Tannebaum PhD, Libby, Anderson PhD, Page, Graap MEd, Ken, Zimand PhD, Elena, Hodges PhD, Larry and Davis PhD, Michael. Cognitive Enhancers as Adjuncts to Psychotherapy: Use of D-Cycloserine in Phobic Individuals to Facilitate Extinction of Fear. Archives of General Psychiatry. 2004. 61. pp. 1136-1144. February 2008.

Davis, Michael, Myers, Karyn M., Ressler, Kerry J., Rothbaum, Barbara O. Facilitation of Extinction of Conditioned Fear by D-Cycloserine: Implications for Psychotherapy. Current Directions in Psychological Science. August 2005.

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