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Randomized controlled experimental study of hydrocortisone and D-cycloserine effects on fear extinction in PTSD.
Inslicht, Sabra S; Niles, Andrea N; Metzler, Thomas J; Lipshitz, Sa'ar L; Otte, Christian; Milad, Mohammed R; Orr, Scott P; Marmar, Charles R; Neylan, Thomas C.
Afiliación
  • Inslicht SS; University of California, San Francisco, San Francisco, CA, USA. Sabra.Inslicht@UCSF.edu.
  • Niles AN; San Francisco VA Health Care System, San Francisco, CA, USA. Sabra.Inslicht@UCSF.edu.
  • Metzler TJ; University of California, San Francisco, San Francisco, CA, USA.
  • Lipshitz SL; San Francisco VA Health Care System, San Francisco, CA, USA.
  • Otte C; University of California, San Francisco, San Francisco, CA, USA.
  • Milad MR; San Francisco VA Health Care System, San Francisco, CA, USA.
  • Orr SP; San Francisco VA Health Care System, San Francisco, CA, USA.
  • Marmar CR; Charité-Universitätsmedizin, Berlin, Germany.
  • Neylan TC; Grossman School of Medicine, New York University, New York, NY, USA.
Neuropsychopharmacology ; 47(11): 1945-1952, 2022 10.
Article en En | MEDLINE | ID: mdl-34799682
Fear extinction underlies prolonged exposure, one of the most well-studied treatments for posttraumatic stress disorder (PTSD). There has been increased interest in exploring pharmacological agents to enhance fear extinction learning in humans and their potential as adjuncts to PE. The objective of such adjuncts is to augment the clinical impact of PE on the durability and magnitude of symptom reduction. In this study, we examined whether hydrocortisone (HC), a corticosteroid, and D-Cycloserine (DCS), an N-methyl-D-aspartate receptor partial agonist, enhance fear extinction learning and consolidation in individuals with PTSD. In a double-blind placebo-controlled 3-group experimental design, 90 individuals with full or subsyndromal PTSD underwent fear conditioning with stimuli that were paired (CS+) or unpaired (CS-) with shock. Extinction learning occurred 72 h later and extinction retention was tested one week after extinction. HC 25 mg, DCS 50 mg or placebo was administered one hour prior to extinction learning. During extinction learning, the DCS and HC groups showed a reduced differential CS+/CS- skin conductance response (SCR) compared to placebo (b = -0.19, CI = -0.01 to -37, p = 0.042 and b = -0.25, CI = -08 to -0.43, p = 0.005, respectively). A nonsignificant trend for a lower differential CS+/CS- SCR in the DCS group, compared to placebo, (b = -0.25, CI = 0.04 to -0.55, p = 0.089) was observed at retention testing, one week later. A single dose of HC and DCS facilitated fear extinction learning in participants with PTSD symptoms. While clinical implications have yet to be determined, our findings suggest that glucocorticoids and NMDA agonists hold promise for facilitating extinction learning in PTSD.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos por Estrés Postraumático / Cicloserina Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Neuropsychopharmacology Asunto de la revista: NEUROLOGIA / PSICOFARMACOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos por Estrés Postraumático / Cicloserina Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Neuropsychopharmacology Asunto de la revista: NEUROLOGIA / PSICOFARMACOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido