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Pharmacological Mechanisms of Modulating Fear and Extinction 

Pharmacological Mechanisms of Modulating Fear and Extinction
Chapter:
Pharmacological Mechanisms of Modulating Fear and Extinction
Author(s):

Boadie W. Dunlop

, Kerry J. Ressler

, and Barbara O. Rothbaum

DOI:
10.1093/med/9780199395125.003.0026
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date: 28 May 2020

Many of the anxiety and stress disorders, particularly those that can be characterized as fear-related disorders, may be particularly tractable because of tremendous progress in the neuroscience of fear modulation over the last several decades. This chapter outlines the processes of fear regulation, extinction, and reconsolidation as mechanisms in preclinical animal models that are likely to underlie the most robust and empirically validated, currently available treatments for fear-related disorders—those based on exposure therapy techniques. It discusses the mechanisms of a number of pharmacological approaches to enhancing extinction of fear, including the use of d-cycloserine, endocannabinoid modulators, methylene blue, and epigenetic regulators. It also examines the burgeoning field of blockade of fear memory reconsolidation, which, although in many ways parallel to extinction modification, offers an additional set of powerful approaches to modulating fear memory formation. Together, such approaches offer exciting and hopeful new neuroscience-based possibilities for these debilitating conditions.

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