Augmentation of cognitive behavioral therapy with pharmacotherapy

K. A. Ganasen, J. C. Ipser, D. J. Stein

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations


There has long been interest in combining pharmacotherapy with psychotherapy, including cognitive behavioral therapy (CBT). More recently, basic research on fear extinction has led to interest in augmentation of CBT with the N-methyl Daspartate (NMDA) glutamate receptor partial agonist D-cycloserine (DCS) for anxiety disorders. In this article, the literature on clinical trials that have combined pharmacotherapy and CBT is briefly reviewed, focusing particularly on the anxiety disorders. The literature on CBT and DCS is then systematically reviewed. A series of randomized placebo-controlled trials on panic disorder, obsessive-compulsive disorder, social anxiety disorder, and specific phobia suggest that low dose DCS before therapy sessions may be more effective compared with CBT alone in certain anxiety disorders. The strong translational foundation of this work is compelling, and the positive preliminary data gathered so far encourage further work. Issues for future research include delineating optimal dosing, and demonstrating effectiveness in real-world settings.

Original languageEnglish
Pages (from-to)687-699
Number of pages13
JournalPsychiatric Clinics of North America
Issue number3
StatePublished - Sep 2010
Externally publishedYes


  • Anxiety disorders
  • Augmentation of cognitive behavioral therapy (CBT)
  • Combining medication with psychotherapy
  • D-Cycloserine (DCS)
  • Fear extinction


Dive into the research topics of 'Augmentation of cognitive behavioral therapy with pharmacotherapy'. Together they form a unique fingerprint.

Cite this