New Study Confirms Medication Can Improve Effectiveness of Psychotherapy to Treat PTSD

Francis S. Lee, M.D., Ph.D., expert on post-traumatic stress disorder (PTSD)
Francis S. Lee, M.D., Ph.D.

2010 NARSAD Independent Investigator Grantee Francis S. Lee, M.D., Ph.D., of Weill Cornell Medical College, served on a multi-institutional research team for a pilot study in which the medication D-cycloserine (DCS), administered simultaneously with a psychotherapy called virtual reality exposure treatment (VRE), significantly improved outcomes for patients with post-traumatic stress disorder (PTSD). The research is reported in the April issue of the journal Neuropsychopharmacology.

Earlier work done by NARSAD Grantee and Foundation Scientific Council Member Kerry J. Ressler, M.D., Ph.D., of Emory University, demonstrated that DCS enhanced the effect of exposure-based psychotherapy for fear of heights, and led to further work showing similar results for obsessive-compulsive disorder, panic disorder and social phobia.

PTSD is a fear response that occurs when a sensory stimulus causes the re-experiencing of a traumatic event in the absence of the original trauma. VRE is a treatment in which patients are repeatedly exposed to a fear stimulus in a safe environment toward the goal of extinguishing the fear memory. The sample group in the DCS trial had PTSD associated with the 2001 terrorist attack on the World Trade Center in New York.

The trial was based on the fact that DCS, an antibiotic sold under the brand name Seromycin to treat infections, also enhances learning. DCS acts in the brain on the N-methyl-D-asparate (NMDA) receptor. NMDA is one of a family of receptors for the neurotransmitter glutamate and plays an essential role in learning and memory.

Read the paper abstract.

Read about Dr. Kerry Ressler’s earlier groundbreaking findings.

Article comments

While this "fix" appears positive, it is not without potential harm to the integrity of the whole person.
The alteration/loss of gut bacteria through use of this antibiotic is a very important negative side effect of this treatment. After one course of antibiotics, it can take years to reestablish gut biome integrity. This treatment, while perhaps enhancing glutamate activity in some way, effectively eliminates a person's ability to derive value from food (chemically-induced malnutrition) or absorb stress reducing B-Vitamins from the gut, while promoting gut inflammation and increased toxicity do to mal-digested food travelling through the gut. As do all antibiotics, loss of intestinal biome integrity also depletes a person's immune system even further. Depression and pain are directly associated with decreased immunity and biome imbalance, and these would also increase for the patient.
I'd recommend some consideration of how to maintain optimal nutrition and restore gut biome health for any patient in this study or future user.

Perhaps the antibiotic Seromycin weakened the strength of infectious brain microbes. That could be the answer to the patient's improvement. A spurious relationship may be at work in the research findings.

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