Journal
EXPERT REVIEW OF NEUROTHERAPEUTICS
Volume 14, Issue 8, Pages 893-910Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1586/14737175.2014.934677
Keywords
brain-derived neurotrophic factor; cognitive behavioral therapy; cortisol; D-cycloserine; exposure therapy; yohimbine; glucocorticoids
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Funding
- National Institute of Mental Health (NIMH) of the National Institutes of Health [R01MH093381]
- NIMH
- International Obsessive Compulsive Disorder Foundation
- National Alliance for Research on Schizophrenia and Depression
- University of South Florida Research Foundation, Inc.
- NIH
- Centers for Disease Control
- Agency for Healthcare Research and Quality
- National Alliance for Research on Schizophrenia and Affective Disorders
- International OCD Foundation
- Tourette Syndrome Association
- Janssen Pharmaceuticals
- Rogers Memorial Hospital
- All Children's Hospital Guild Endowed Chair
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Translating findings from basic science, several compounds have been identified that may enhance therapeutic outcomes and/or expedite treatment gains when administered alongside exposure-based treatments. Four of these compounds (referred to as cognitive enhancers) have been evaluated in the context of randomized controlled trials for anxiety disorders (e. g., specific phobias, panic disorder, social anxiety disorder), obsessive-compulsive disorder and post-traumatic stress disorder. These cognitive enhancers include D-cycloserine, yohimbine hydrochloride, glucocorticoids and cortisol and brain-derived neurotrophic factor. There is consistent evidence that cognitive enhancers can enhance therapeutic outcomes and/or expedite treatment gains across anxiety disorders, obsessive-compulsive disorder and post-traumatic stress disorder. Emerging evidence has highlighted the importance of within-session fear habituation and between-session fear learning, which can either enhance fear extinction or reconsolidate of fear responses. Although findings from these trials are promising, there are several considerations that warrant further evaluation prior to widespread use of cognitive enhancers in exposure-based treatments. Consistent trial design and large sample sizes are important in future studies of cognitive enhancers.
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