Editing Phobia (section)

== Research directions ==
Before the development of pharmacotherapy, the treatment of phobias and mental health disorders relied solely on therapy such as CBT. Although therapy can be incredibly effective for many, it does not always achieve the desired effect. [[Interventional psychiatry]] is an additional branch in medicine that has expanded treatment options, and further research continues to explore effectiveness and applications. [[Electroconvulsive therapy]] (ECT) and [[transcranial magnetic stimulation]] (TMS) are two examples of device-based interventions widely utilized.<ref>{{Cite web |date=2021 |title=Electroconvulsive Therapy (ECT) |url=https://www.healthwise.net/stanford/Content/StdDocument.aspx?DOCHWID=ty1541 |access-date=2022-03-16 |website=Stanford Health Care |publisher=Healthwise |language=en}}</ref><ref>{{Cite web |title=Transcranial Magnetic Stimulation (TMS) |url=https://www.healthwise.net/stanford/Content/StdDocument.aspx?DOCHWID=acm0577 |access-date=2022-03-16 |website=Stanford Health Care |publisher=Healthwise |language=en}}</ref> In terms of use in treating phobias and anxiety disorders as a whole, TMS is being explored as an augmentation option for those who do not have the desired response to other therapeutic options or side effects from medications. A majority of research has been conducted exploring the use of TMS in PTSD and generalized anxiety disorder. A meta‐analysis conducted in 2019 found only two clinical trials for the use of TMS in specific phobias, one of which explored anxiety and avoidance rates in individuals with acrophobia. Although the study found decreased rates in both anxiety and avoidance after two TMS sessions because of the limited number of studies and small sample size, few conclusions can be made.<ref>{{cite journal | vauthors = Cirillo P, Gold AK, Nardi AE, Ornelas AC, Nierenberg AA, Camprodon J, Kinrys G | title = Transcranial magnetic stimulation in anxiety and trauma-related disorders: A systematic review and meta-analysis | journal = Brain and Behavior | volume = 9 | issue = 6 | pages = e01284 | date = June 2019 | pmid = 31066227 | pmc = 6576151 | doi = 10.1002/brb3.1284 }}</ref> D-cycloserine (DCS), a partial N-methyl-D-aspartate agonist, is an additional investigational approach to augmentation specific phobias that a meta-analysis suggested had better outcomes and less symptom severity when utilized before initiating CBT.<ref>{{cite journal | vauthors = Mataix-Cols D, Fernández de la Cruz L, Monzani B, Rosenfield D, Andersson E, Pérez-Vigil A, Frumento P, de Kleine RA, Difede J, Dunlop BW, Farrell LJ, Geller D, Gerardi M, Guastella AJ, Hofmann SG, Hendriks GJ, Kushner MG, Lee FS, Lenze EJ, Levinson CA, McConnell H, Otto MW, Plag J, Pollack MH, Ressler KJ, Rodebaugh TL, Rothbaum BO, Scheeringa MS, Siewert-Siegmund A, Smits JA, Storch EA, Ströhle A, Tart CD, Tolin DF, van Minnen A, Waters AM, Weems CF, Wilhelm S, Wyka K, Davis M, Rück C, Altemus M, Anderson P, Cukor J, Finck C, Geffken GR, Golfels F, Goodman WK, Gutner C, Heyman I, Jovanovic T, Lewin AB, McNamara JP, Murphy TK, Norrholm S, Thuras P | display-authors = 6 | title = D-Cycloserine Augmentation of Exposure-Based Cognitive Behavior Therapy for Anxiety, Obsessive-Compulsive, and Posttraumatic Stress Disorders: A Systematic Review and Meta-analysis of Individual Participant Data | journal = JAMA Psychiatry | volume = 74 | issue = 5 | pages = 501–510 | date = May 2017 | pmid = 28122091 | doi = 10.1001/jamapsychiatry.2016.3955 | doi-access=free | s2cid = 205144078 | url = https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2599177?redirect=true | hdl = 2066/174490 | hdl-access = free }}{{Erratum|doi=10.1001/jamapsychiatry.2017.0144|pmid=28297011|checked=yes}}</ref>