Emory University researchers will embark on a study they hope will enhance the treatment of post-traumatic stress disorder (PTSD) and help soldiers who are affected get better faster. The risk for PTSD among Iraq War veterans is estimated to be 18 percent, according to a 2004 study that examined the mental health impact of the war. According to the U.S. Department of Veterans Affairs, the estimated lifetime prevalence of PTSD among American Vietnam war veterans is 30.9 percent for men and 26.9 percent for women. PTSD is a serious condition that can become a chronic problem, with devastating life-altering effects on soldiers and their families.
Researchers Barbara Rothbaum, PhD, ABPP, and Kerry Ressler, MD, PhD, will lead a 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, 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, and was very successful. Drs. Ressler and Davis are faculty members at the Yerkes National Primate Research Center, the Department of Psychiatry and Behavioral Sciences in Emory University School of Medicine, and the Center for Behavioral Neuroscience,
"We were very excited about the results of the acrophobia study and we are delighted to have the opportunity to move forward with the PTSD study," says Dr. Rothbaum, an Emory professor of psychiatry and director of Emory's Trauma and Anxiety Recovery Program. "A large part of the problem PTSD patients have is the fear of the memory itself. Although the memories will never really go away, we believe that the DCS will make it easier for patients to learn how not to fear their memories."
Co-investigators in the study will include Dr. Davis and Emory psychiatry faculty Erica Duncan, MD and Maryrose Gerardi, PhD. A 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.
"Persons with PTSD experience both psychological and physical effects, and just like any other illness, PTSD can worsen and become harder to treat the longer someone waits to be treated," says Dr. Ressler. "We hope this study will open up some new doors that will help us get people back to their normal lives as soon as possible."
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.