Enhancing Fear Extinction: Pharmacological Approaches
Fear Extinction January 1, 2023 Olga Y. Ponomareva, Robert J. Fenster, Kerry J. Ressler
Extinction—the process by which a learned conditioned association fades over time and with new learning—is central to fear-related disorders such as phobias, panic disorder, OCD, and PTSD, and underlies gold-standard therapies like prolonged exposure and cognitive processing therapy. Pharmacological modulators of extinction are promising treatment targets. This review covers emerging psychopharmacological agents that may facilitate extinction: D-cycloserine, scopolamine, losartan, ketamine, and MDMA. It also surveys recent advances in molecular pathways relevant to extinction and inhibitory learning, including cannabinoid, BDNF, HPA-axis signaling, and neurosteroid compounds.