Department of Psychological and Brain Sciences, Boston University, 648 Beacon Street, 6th Floor, Boston, MA, 02215-2002, USA,
Curr Psychiatry Rep. 2015 Jan;17(1):532. doi: 10.1007/s11920-014-0532-2.
Although cognitive behavioral therapy (CBT) is a generally effective treatment for treating anxiety disorders, there is clearly still room for further improvements. Recent advances in neuroscience of extinction learning led to novel clinical strategies to augment exposure-based treatments with d-cycloserine (DCS), a partial agonist at the glycine recognition site of the glutamatergic N-methyl-D-aspartate receptor. This review provides an update on the current knowledge of DCS as an augmentation strategy of CBT for anxiety disorders. The adequacy of the CBT to be augmented, the dose of DCS, and the timing and duration of augmentation efforts all appear to be important moderating variables. Moreover, there is evidence that DCS may also augment fear memory reconsolidation if the fear level remains high after the exposure. Future studies need to examine whether DCS can augment CBT when administered after exposure in order to develop a tailored administration strategy to maximize its clinical utility.
虽然认知行为疗法（CBT）是治疗焦虑症的一种普遍有效的治疗方法，但显然仍有进一步改进的空间。最近在消退学习的神经科学方面的进展，导致了新的临床策略，即用 d-环丝氨酸（DCS）来增强基于暴露的治疗，DCS 是谷氨酸能 N-甲基-D-天冬氨酸受体甘氨酸识别位点的部分激动剂。本文综述了 DCS 作为焦虑症 CBT 增强策略的最新知识。需要增强的 CBT 的充分性、DCS 的剂量、增强努力的时间和持续时间似乎都是重要的调节变量。此外，有证据表明，如果暴露后恐惧水平仍然很高，DCS 也可以增强恐惧记忆再巩固。未来的研究需要检查 DCS 是否可以在暴露后给药时增强 CBT，以制定个性化的给药策略，最大限度地提高其临床应用。
