Fears Can Be Treated Successfully With Combination of Drugs and Behavior Therapy

Medication combined with behavioral therapy can be effective in helping individuals fight their fears, says Michael Davis, PhD, Robert W. Woodruff Professor of Psychiatry and Behavioral Sciences and a faculty member at Yerkes National Primate Research Center at Emory University. Dr. Davis presented an update on his research at the Neuroscience 2007 meeting, the annual meeting of the Society for Neuroscience held in San Diego.

Dr. Davis described how a greater understanding of the brain's neurotransmitters has led to improved therapies for reducing or inhibiting fears. With the use of cognitive therapy, as well as medications such as D-cycloserine, researchers have been able to help patients who suffer from anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder and social phobia.

The key to successful treatment, Dr. Davis has found in his research, is to improve the process that makes cognitive behavioral therapy work. The scientific term for this process is fear extinction. The discovery by Dr. Davis that a type of receptor in the brain, called the NMDA receptor, is critical for this extinction process has led to the idea of using a drug called D-cycloserine in conjunction with cognitive behavioral therapy.

"We are trying to improve the lives of people who may have an obsessive-compulsive disorder so severe that they cannot get out of bed as they try to decide which foot should go first," says Dr. Davis. " We want to help the person who has a panic attack crossing a bridge to no longer feel terrified to cross. We want to help someone who has nightmares from reliving a traumatic experience."

Anxiety disorders are the most common type of psychiatric illness. More than 19 million adults and children suffer from problems related to anxiety disorders, says Dr. Davis.

"Medications have been extremely helpful in treating many of these individuals, but they can have side effects or not always work," says Dr. Davis. "Neuroscientists in my lab are looking at areas of the brain related to the extinction of fears and are trying to better understand the underlying mechanisms to help determine the most effective treatment to help patients resolve their anxieties and lead a more normal life."

The study is supported by the National Institute of Mental Health, the Woodruff Foundation, the Center for Behavioral Neuroscience of the National Science Foundation and the Yerkes National Primate Research Center of Emory University.