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Pilot-controlled trial of d-cycloserine for the treatment of post-traumatic stress disorder

Uriel Heresco-Levy , Ilana Kremer , Daniel C. Javitt , Rodica Goichman , Alon Reshef , Monica Blanaru , Tamar Cohen
DOI: http://dx.doi.org/10.1017/S1461145702003061 301-307 First published online: 1 December 2002

Abstract

Dysfunction of glutamatergic neurotransmission may be relevant to the pathogenesis of post-traumatic stress disorder (PTSD). Preclinical and clinical evidence suggests that PTSD symptoms could be alleviated following enhancement of neurotransmission mediated at the N-methyl-d-aspartate (NMDA) subtype of glutamate receptors. Eleven patients with chronic PTSD participated in a double-blind, placebo-controlled, cross-over trial with 50 mg/d d-cycloserine which acts as a partial agonist at the glycine regulatory site on the NMDA receptor. d-cycloserine treatment resulted in significant improvements in numbing, avoidance, and anxiety symptoms; however, similar effects were also observed during placebo treatment. In addition, d-cycloserine treatment resulted in a significant (p=0.03), reduction in the perseverative error scores as measured by the Wisconsin Card Sorting Test. This pilot study is the first to assess the efficacy of a NMDA receptor modulator for PTSD treatment and its results warrant further, larger-scale investigation.

Key words
  • d-cycloserine
  • N-methyl-d-aspartate receptor
  • post-traumatic stress disorder