NEW ORLEANS, Nov. 10 — 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.
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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.
Results 'pretty convincing'
“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.
Not for everyone
However, David Kupfer, a Falls Church, Va., 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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