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D-Cycloserine + Virtual Reality Exposure therapy is a combination treatment protocol developed and evaluated by Weill Medical College of Cornell University for the treatment of post-traumatic stress disorder (PTSD), particularly in military veterans. D-Cycloserine (DCS) is a small molecule antibiotic repurposed as a cognitive enhancer that acts as a partial agonist at the glycine binding site of the N-methyl-D-aspartate (NMDA) receptor. By facilitating NMDA receptor-mediated glutamatergic neurotransmission, DCS enhances fear extinction learning and memory consolidation when administered prior to exposure therapy. Virtual Reality Exposure (VRE) provides a controlled, immersive environment for patients to confront and process traumatic memories. Clinical trials led by Dr. JoAnn Difede have demonstrated that the adjunctive use of DCS with VRE can accelerate and enhance the therapeutic effects of exposure therapy, showing particular efficacy in reducing symptoms like irritability and sleep disturbances.
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