CN Tower here I come —
but I'd rather do it virtually

Tuberculosis drug reaches new heights treating
acrophobics; but what about the pharmaphobes?

BY CHRIS WILLIAMS

A drug long-regarded as a cornerstone of treatment for tuberculosis (TB) appears set to enjoy a new (and potentially more lucrative) role: helping phobic patients conquer their fears.

In trials at Emory University School of Medicine in Atlanta, Georgia, the anti-bacterial D-cycloserine (DCS) helped patients with a fear of heights, or acrophobia, manage their terror in simulated rides on a glass elevator. The drug was effective against acrophobia at a dose of just 50mg, 1/10th of the dose normally given to TB patients.

Michael Davis, of Emory University's Department of Psychiatry and Behavioural Sciences, told the annual meeting of the Society for Neuroscience that the drug could also help people with social and other phobias, as well as post-traumatic stress disorder and obsessive-compulsive disorder. He calculated that in the US alone, 19 million people potentially stand to benefit from the treatment.

He said the drug was not being proposed as a long-term treatment for phobia. Rather, it would be taken before extinction therapy sessions in which patients are taught to confront their phobia head-on. The combination of a drug and virtual reality simulation has never been tried before.

Davis conducted therapy sessions with 30 acrophobic patients, of whom 10 received a placebo and 20 were given DCS. After two sessions, the placebo group reported a 10% decrease in anxiety levels on a subjective scale, while the treatment group reported a 60% improvement.

Three months later, the treated group had entered twice as many high-rise buildings and were more likely to travel on suspension bridges and elevators. Davis concluded that two sessions with the drug are equivalent to eight sessions without. He noted that four months of weekly sessions costs about $3,000 US in the US, and the dropout rate currently approaches 40%.

Davis' team next plans to test the drug on people who fear public speaking. "They'll be presented with DCS and a virtual audience," he says. Hold the virtual hecklers.