Hofmann 2006.

Methods	Design: Randomised, double‐blind, placebo controlled augmentation trial Study duration: 5 weeks Follow‐up: 1 month Country: USA
Participants	Sample size: 27 adult patients eligible and agreed to participate Recruitment: self‐referred from the community to one of three research clinics Inclusion criteria ‐ diagnostic classification criteria: DSM‐IV primary diagnosis of SAnD with significant public speaking anxiety Inclusion criteria ‐ rating scales: Anxiety Disorder Interview Schedule for Adults (ADIS‐IV) and self‐reported fear of public speaking Included disorders: SAnD and co‐morbid diagnoses Co‐morbidities: 11 individuals had at least 1 additional DSM‐IV Axis I diagnosis; 9 had an additional anxiety disorder and 4 had an additional mood disorder Gender: 70% male Mean age: 33.70 years (SD 10.02 years) Ethnicity: 59.3% White, 14.8% Asian, 11.1% Hispanic, 11.1% African American Pharmacotherapy during the study: Naturalistic prescribing allowed; 1 participant was taking a benzodiazepine, 9 participants were taking an antidepressant, 1 participant was taking a beta‐blocker, and 3 participants were taking stimulants
Interventions	Intervention: Participants received 50 mg doses of DCS administered 1 hour prior to sessions 2 to 5 of 5‐weekly individual or group exposure therapy (n = 12) Comparison: Participants received placebo pill administered 1 hour prior to sessions 2 to 5 of 5‐weekly individual or group exposure therapy (n = 15) Therapists: Sessions were administered by therapists who were supervised and trained by 2 of the article authors
Outcomes	Withdrawals; anxiety: LSAS; adverse events
Notes	Funding from Industry: Unclear Medication funded by industry: Unclear Any authors work for industry: Unclear Study ID: NCT00515879
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	'Patients were randomised to either adjunctive DCS or pill placebo administered as a 50‐mg pill on each of 4 occasions.' Study was randomised but method of sequence generation not stated. However, since allocation concealment was adequate we assume that randomisation method was adequate
Allocation concealment (selection bias)	Low risk	'The random allocation sequence was generated by numbering containers with the medication. The sequence was generated prior to allocating participants and was concealed until the end of the study.' Matching d‐cycloserine or placebo was given
Blinding of participants and personnel (performance bias) All outcomes	Low risk	'All of the individuals involved inpatient care, evaluation, or study supervision were blind to group assignment until the end of the study.'
Blinding of outcome assessment (detection bias) All outcomes	Low risk	'All of the individuals involved inpatient care, evaluation, or study supervision were blind to group assignment until the end of the study.'
Incomplete outcome data (attrition bias) All outcomes	Low risk	Of the 32 eligible participants, 5 had to be excluded from analysis for the following reasons: 4 patients withdrew after signing the consent form or after the initial treatment session, and 1 patient was excluded owing to a protocol violation. Twenty‐seven patients (12 who received exposure therapy plus DCS and 15 who received exposure therapy plus placebo) completed the 5‐session treatment. Twenty‐three patients (10 who received exposure therapy plus DCS and 13 who received exposure therapy plus placebo) completed the 1‐month follow‐up assessment.
Selective reporting (reporting bias)	High risk	No information was provided on the following outcomes as per protocol ‐ Social Phobic Disorders Severity and Change Form, Quality of Life Enjoyment and Satisfaction Questionnaire, Range of Impaired Functioning Tool
Other bias	Unclear risk	A large percentage of patients (11 patients, 40.7%) were receiving concomitant medications, which might have confounded the results