D-Cycloserine attenuates reactivity to smoking cues in nicotine dependent smokers: a pilot investigation.
Increasing evidence indicates that smoking cues contribute to nicotine self-administration and attenuating conditioned reactivity to smoking cues may aid abstinence of smoking and prevention of smoking relapse in individuals with nicotine dependence. Based on prior studies showing that the partial N-methyl-D-aspartate (NMDA) agonist D-cycloserine (DCS) facilitates extinction of learned fear during behavioral exposure therapy in humans and facilitates extinction of cocaine-induced conditioned place preference in animals, we evaluated whether DCS would have potential for reducing reactivity to smoking cues when combined with cue exposure treatment in humans with nicotine dependence. In this double-blind placebo-controlled pilot laboratory study, 25 smokers were recruited from the general community and randomized to DCS or placebo, plus cue exposure therapy. DCS significantly attenuated smoking cue reactivity in response to in-vivo smoking cues based on physiological reactivity and subjective urge-to-smoke ratings and led to a significantly smaller expired carbon monoxide (CO) level at the one-week follow-up compared to placebo, although exploratory analyses indicated no effect on smoking behavior overall. These findings provide promising support for DCS combined with cue exposure therapy in attenuating conditioned reactivity to smoking cues.
Santa Ana
Elizabeth J
EJ
VA Connecticut Healthcare System, Department of Psychiatry, Division of Substance Abuse, West Haven, CT 06516, USA. elizabeth.santaana@yale.edu
Rounsaville
Bruce J
BJ
Frankforter
Tami L
TL
Nich
Charla
C
Babuscio
Theresa
T
Poling
James
J
Gonsai
Kishorchandra
K
Hill
Kevin P
KP
Carroll
Kathleen M
KM
D000328:Adult; D016739:Behavior, Addictive / Q000188:drug therapy / Q000628:therapy; D001944:Breath Tests; D002248:Carbon Monoxide / Q000378:metabolism; D003131:Combined Modality Therapy / Q000379:methods; D003367:Cotinine / Q000652:urine; D003463:Cues; D003523:Cycloserine / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005108:Extinction, Psychological / Q000187:drug effects; D005260:Female; D005712:Galvanic Skin Response / Q000187:drug effects; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011613:Psychotherapy / Q000379:methods; D014029:Tobacco Use Disorder / Q000378:metabolism / Q000523:psychology* / Q000628:therapy* / Q000652:urine
D002248:Carbon Monoxide; D003523:Cycloserine; D003367:Cotinine