In groundbreaking work, Kerry J. Ressler, M.D., Ph.D., with the aid of a Young Investigator Grant, discovered that targeted medication can improve the effect of psychotherapy. This paradigm-shifting work showed that treatment with D-cycloserine (or DCS) enhanced the effect of exposure-based psychotherapy for fear of heights, and led to further work showing similar results for obsessive-compulsive disorder (OCD), panic disorder, and social phobia.

In 2004, Dr. Ressler and colleagues conducted a double-blind trial of DCS vs. placebo using 28 people diagnosed with acrophobia (fear of heights). Patients received two sessions of behavioral exposure therapy using virtual reality exposure to heights within a virtual glass elevator. Before each session, subjects received single doses of placebo or DCS. Symptoms were evaluated one week and three months after treatment.

The researchers discovered that the patients receiving the DCS treatment had significantly larger reductions of acrophobia symptoms compared to the patients receiving the placebo. Participants in the study were evaluated based on symptoms in the real world, general measures of overall improvement, and electrodermal skin fluctuation during virtual reality. Symptoms were improved across all measurements―at both one-week check-ups and three-month follow-ups.

“Traditional pharmacological approaches to treating psychiatric disorders focus on correcting presumed biochemical abnormalities,” said Dr. Ressler and colleagues. “However, some disorders, particularly the anxiety-related disorders exemplified by specific phobia, have an emotional learning component to them that can be facilitated with psychotherapy.”

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