Patients rated their 10-most disturbing stimuli on the 1-100 Subjective Unit of Distress Scale. The clinician then started working on the lower-rated stimuli first, and once a rating was decreased by at least 50%, a more challenging stimulus was tackled until all the ratings were cut by 50% of baseline, or until the 10th session was completed.

The authors found that the patients who received D-cycloserine had a more rapid decline in obsession-related fear rating through four exposure sessions, with the difference becoming significant at session four (t=2.3, P<0.05).

In addition, patients in the D-cycloserine group required an average of two fewer therapy sessions before reaching a greater than 50% decline in the distress scale ratings. At the end of their treatment sessions, however, there were no significant differences between the 14 remaining patients in the active drug group, or 11 patients in the placebo group.

"This offers another therapeutic approach where we can attempt to manipulate the memory process and the brain's reward/punishment system so people can learn healthier responses to various cues," Dr. Kushner said.

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