Category: Translational

Symposium

Yohimbine Enhancement of Extinction: Trial Findings for Claustrophobia, Aviophobia, SAD, and PTSD

Friday, November 17
8:30 AM - 10:00 AM
Location: Aqua Salon C & D, Level 3, Aqua Level

Keywords: Translational Research | Exposure
Presentation Type: Symposium

Preliminary animal research suggested that yohimbine hydrochloride, a selective competitive alpha2-adrenergic receptor antagonist, accelerates fear extinction and converts ineffective extinction regimens (long intertrial intervals) to effective ones. Based on these findings, we conducted a series of randomized clinical trials in humans. The first randomized placebo-controlled trial in humans replicated this finding in claustrophobic participants. Claustrophobic participants (N = 24) were randomized to administration of yohimbine or placebo prior to 2 one-hour in vivo exposure sessions. Results showed that both conditions improved significantly at posttreatment with no significant difference between groups. Consistent with prediction the yohimbine group showed significantly greater improvement at the one-week follow-up behavioral assessment (d = 1.68). The second study was in the context of aviophobia. Participants with a diagnosis of Specific Phobia (fear of flying; N = 67) were randomized to four sessions of virtual reality exposure therapy (VRET) combined with yohimbine, or pill-placebo. Consistent with the first study, results showed that both groups improved significantly from pre- to post-treatment with no between group differences. However, contrary to the first study, this trial did not include a follow-up. The third study focused on social anxiety disorder. Participants (N = 40) with a diagnosis of social anxiety disorder were randomized to placebo or yohimbine one hour prior to each of four exposure sessions. Yohimbine augmentation, relative to placebo, resulted in faster improvement and better outcomes on measures of social anxiety and mood. Finally, we conducted a randomized, placebo-controlled trial investigating the effect of a single administration of yohimbine (paired with the first session of imaginal exposure) on outcome of prolonged exposure therapy in 40 veterans with PTSD. Consistent with prediction, initial analyses suggest yohimbine augmented the imaginal exposure therapy relative to placebo. In all trials, yohimbine was well tolerated with no serious adverse events. 

Mark B. Powers

Research Associate Professor
University of Texas at Austin

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Yohimbine Enhancement of Extinction: Trial Findings for Claustrophobia, Aviophobia, SAD, and PTSD



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