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Pills to overcome your
worst phobias?
NEW ORLEANS, Louisiana (AP) -- Scientists
say a pill may help people overcome their worst phobias.
In a small study released Monday, a drug already on the
market for tuberculosis helped people who were terrified
of heights get over that fear with only two therapy sessions
instead of the usual seven or eight.
The study, led by Michael Davis, a professor of psychiatry
and behavioral sciences at the Emory University School of
Medicine, was described at a session about unlearning fears
at the Society for Neuroscience meeting.
Davis based his work on research that had found the transmission
of a certain protein to a brain receptor were critical to
overcoming fear. He found that the TB drug, D-cycloserine,
aids the transmission of the crucial protein.
The drug, sold by Eli Lilly and Co. under the brand name
Seromycin, doesn't dissolve fear. But in rats, it helped
them unlearn fears faster, Davis said. Since it was already
approved for use in people, he and Barbara O. Rothbaum,
director of the school's trauma and anxiety recovery program,
tested it on 28 acrophobics, people afraid of heights.
Each got a pill just before their two virtual reality therapy
sessions, in which computerized goggles are used to simulate
going up a glass elevator in a hotel lobby. Nobody knew
whether the pill was a dummy or one of two doses of D-cycloserine,
the 500 mg used for TB or one-tenth that dose.
One participant dropped out. When checked one week after
and three months after the second session, the 10 patients
who had gotten placebos did slightly better than they had
at the start. But the 17 on drug -- the dose didn't seem
to matter -- did as well as or better than people who had
finished the usual course of eight treatments, Davis said.
"That's pretty powerful stuff, and pretty convincing,"
said Alan Steinberg, associate director of the National
Center for Child Traumatic Stress at UCLA.
And those who had taken the drug were twice as likely as
those on the placebo to be going up in elevators, driving
over high bridges and doing other things that fear of panic
attacks had kept them from doing before the therapy.
"That's an especially positive aspect of these results,"
said Mark Bouton, a psychology professor at the University
of Vermont. Many times, he noted, fear unlearned in one
situation -- elevators, for instance -- may still show up
in other areas, such as high bridges or rooftop restaurants.
However, David Kupfer, a Falls Church, Virginia, cognitive
behavioral therapist with a specialty in phobias and other
anxiety disorders, said that even if larger studies confirm
the findings, he probably would use it only in a few patients.
Other research has indicated that people who go through
therapy unmedicated for such problems do better, in the
long run, he said.
"People learn ... that they are the powerful agent
of change, not the medication," he said.
However, Kupfer said, it could be useful
for people who have trouble with exposure therapy, whether
it is virtual reality, imagination or going out to face
the fear.
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