Two more RCTs are investigating the additive value of supplementing VRET and PE with a cognitive enhancer called
D-Cycloserine (DCS). DCS, an N-methyl-d-aspartate partial agonist, has been shown to facilitate extinction learning
in laboratory animals when infused bilaterally within the amygdala (the “fight or flight” conditioning center in the
brain) prior to extinction training.
Recent evidence of both VRET and DCS effectiveness has been reported by JoAnne Difede and her colleagues.16 Significant funding for these RCTs underscores the interest the DoD and VA have in exploring
innovative VRET approaches.