--Emory University researchers are embarking on a study they hope will enhance the treatment of post-traumatic stress disorder (PTSD) and help soldiers who are affected get better faster. PTSD is a serious condition that can become a chronic problem, with devastating life-altering effects on soldiers and their families. Barbara Rothbaum, PhD, ABPP, and Kerry Ressler, MD, PhD, are leading the study, funded by the National Institute of Mental Health (NIMH), using the drug d-cycloserine (DCS) combined with virtual reality therapy.
DCS binds to neurotransmitter receptors in the amygdala called NMDA (N-methyl-D-aspartate) receptors. The mechanisms governing the fear response are located in that region of the brain. Previous rodent studies of DCS by Dr. Ressler and Michael Davis, PhD, at Emory University School of Medicine and Yerkes National Primate Research Center, have shown that it has a positive effect on the extinction of fear. The first human trial using DCS with Virtual Reality Exposure Therapy for acrophobia, or fear of heights, was completed in 2004 by Drs. Davis, Rothbaum and Ressler, and was very successful.
Soldiers returning from Iraq who have been diagnosed with PTSD will be eligible for the study. A total of 150 volunteers will be enrolled. Participants will be randomized into three separate groups, using virtual reality exposure therapy with each group: those who receive a placebo, those who receive DCS and those who receive alprazalam (Xanax). Participants will take one pill before each virtual reality therapy session for a total of only four pills.
Each group will meet with a trained therapist once a week for five weeks. The virtual reality exposure therapy will portray scenes, sounds, vibrations and odors related to combat in Iraq. Researchers will also test galvanic skin response and heart rate, and will measure the level of cortisol, a stress hormone that is in the saliva.
Dr. Rothbaum is a professor of psychiatry and behavioral sciences, and director of the Trauma and Anxiety Recovery Program in Emory University School of Medicine. Drs. Ressler and Davis are faculty members at the Yerkes National Primate Research Center, professors of psychiatry and behavioral sciences at Emory School of Medicine, and members of the Center for Behavioral Neuroscience,
Co-investigators in the study will include Dr. Davis and other Emory psychiatry faculty, Erica Duncan, MD and Maryrose Gerardi, PhD. The Virtual Iraq module was developed by Dr. Skip Rizzo and colleagues at the Institute for Creative Technologies and School of Gerontology at the University of Southern California.
For more information or to enroll in the study, call Jeremy Higgins, study coordinator, at (404) 712-8300 or email at tarp@emory.edu.
Drs. Ressler and Davis are co-authors of a patent for the use of D-cycloserine for the specific enhancement of learning during psychotherapy and are co-founders of SyneurRx Pharmaceuticals, LLC, which holds the patent rights for this indication. The terms of these arrangements have been reviewed and approved by Emory University in accordance with its conflict of interest policies.
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