Trial reportThe American journal of psychiatry2014
A randomized, double-blind evaluation of D-cycloserine or alprazolam combined with virtual reality exposure therapy for posttraumatic stress disorder in Iraq and Afghanistan War veterans.
Trial report in The American journal of psychiatry, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 142 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
142 citing papers in PubMed, 11 syntheses or guidelines pooled it, 387 citations in OpenAlex.
- Pooled it
- Pharmacological memory modulation to augment trauma-focused psychotherapy for PTSD: a systematic review of randomised controlled trials.Translational psychiatry · 2023Pooled it
- Rational and Translational Implications of D-Amino Acids for Treatment-Resistant Schizophrenia: From Neurobiology to the Clinics.Biomolecules · 2022Pooled it
- Virtual Reality Exposure Therapy for Armed Forces Veterans with Post-Traumatic Stress Disorder: A Systematic Review and Focus Group.International journal of environmental research and public health · 2022Pooled it
- Long-term outcomes of psychological treatment for posttraumatic stress disorder: a systematic review and meta-analysis.Psychological medicine · 2021Pooled it
- The Effect of Concurrent Depression on PTSD Outcomes in Trauma-Focused Psychotherapy: A Meta-Analysis of Randomized Controlled Trials.Behavior therapy · 2021Pooled it
- Interventions for adults with a history of complex traumatic events: the INCiTE mixed-methods systematic review.Health technology assessment (Winchester, England) · 2020Pooled it
- Technological Competence Is a Pre-condition for Effective Implementation of Virtual Reality Head Mounted Displays in Human Neuroscience: A Technological Review and Meta-Analysis.Frontiers in human neuroscience · 2019Pooled it
- A Meta-Analysis of D-Cycloserine in Exposure-Based Treatment: Moderators of Treatment Efficacy, Response, and Diagnostic Remission.The Journal of clinical psychiatry · 2017Pooled it
- D-cycloserine augmentation of behavior therapy for anxiety and obsessive-compulsive disorders: A meta-analysis.PloS one · 2017Pooled it
- Augmentation of cognitive and behavioural therapies (CBT) with d-cycloserine for anxiety and related disorders.The Cochrane database of systematic reviews · 2015Pooled it
- Long term structural and functional neural changes following a single infusion of Ketamine in PTSD.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2023Trial
- Cannabinoid modulation of corticolimbic activation during extinction learning and fear renewal in adults with posttraumatic stress disorder.Neurobiology of learning and memory · 2023Trial
- Randomized controlled experimental study of hydrocortisone and D-cycloserine effects on fear extinction in PTSD.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022Trial
- A clinical trial of a patient-customized virtual reality intervention for tinnitus.Scientific reports · 2022Trial
- A randomized controlled trial of 3,4-methylenedioxymethamphetamine (MDMA) and fear extinction retention in healthy adults.Journal of psychopharmacology (Oxford, England) · 2022Trial
- The temporal sequence of change in PTSD symptoms and hypothesized mediators in Cognitive Processing Therapy and Written Exposure Therapy for PTSD.Behaviour research and therapy · 2021Trial
- Posttraumatic Stress Disorder Symptom Cluster Structure in Prolonged Exposure Therapy and Virtual Reality Exposure.Journal of traumatic stress · 2021Trial
- Simultaneous Application of Transcranial Direct Current Stimulation during Virtual Reality Exposure.Journal of visualized experiments : JoVE · 2021Trial
- Dose Timing of D-Cycloserine to Augment Exposure Therapy for Social Anxiety Disorder: A Randomized Clinical Trial.JAMA network open · 2020Trial
82 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
objectiveThe authors examined the effectiveness of virtual reality exposure augmented with D-cycloserine or alprazolam, compared with placebo, in reducing posttraumatic stress disorder (PTSD) due to military trauma.
methodAfter an introductory session, five sessions of virtual reality exposure were augmented with D-cycloserine (50 mg) or alprazolam (0.25 mg) in a double-blind, placebo-controlled randomized clinical trial for 156 Iraq and Afghanistan war veterans with PTSD.
resultsPTSD symptoms significantly improved from pre- to posttreatment across all conditions and were maintained at 3, 6, and 12 months. There were no overall differences in symptoms between D-cycloserine and placebo at any time. Alprazolam and placebo differed significantly on the Clinician-Administered PTSD Scale score at posttreatment and PTSD diagnosis at 3 months posttreatment; the alprazolam group showed a higher rate of PTSD (82.8%) than the placebo group (47.8%). Between-session extinction learning was a treatment-specific enhancer of outcome for the D-cycloserine group only. At posttreatment, the D-cycloserine group had the lowest cortisol reactivity and smallest startle response during virtual reality scenes.
conclusionsA six-session virtual reality treatment was associated with reduction in PTSD diagnoses and symptoms in Iraq and Afghanistan veterans, although there was no control condition for the virtual reality exposure. There was no advantage of D-cycloserine for PTSD symptoms in primary analyses. In secondary analyses, alprazolam impaired recovery and D-cycloserine enhanced virtual reality outcome in patients who demonstrated within-session learning. D-cycloserine augmentation reduced cortisol and startle reactivity more than did alprazolam or placebo, findings that are consistent with those in the animal literature.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.