title: Changes in cue reactivity and attentional bias following experimental cue exposure and response prevention: a laboratory study of the effects of D-cycloserine in heavy drinkers.
abstract: BACKGROUND
  The effects of D-cycloserine (DCS) in animal models of anxiety disorders and addiction indicate a role for N-methyl D-aspartate (NMDA) receptors in extinction learning. Exposure/response prevention treatments for anxiety disorders in humans are enhanced by DCS, suggesting a promising co-therapy regime, mediated by NMDA receptors. Exposure/response prevention may also be effective in problematic drinkers, and DCS might enhance habituation to cues in these individuals. Since heavy drinkers show ostensible conditioned responses to alcohol cues, habituation following exposure/response prevention should be evident in these drinkers, with DCS enhancing this effect.
  
  
  OBJECTIVE
  The objective of this study is to investigate the effect of DCS on exposure/response prevention in heavy drinkers.
  
  
  METHODS
  In a randomised, double-blind, placebo-controlled study, heavy social drinkers recruited from the community received either DCS (125 mg; n = 19) or placebo (n = 17) 1 h prior to each of two sessions of exposure/response prevention. Cue reactivity and attentional bias were assessed during these two sessions and at a third follow-up session. Between-session drinking behaviour was recorded.
  
  
  RESULTS
  Robust cue reactivity and attentional bias to alcohol cues was evident, as expected of heavy drinkers. Within- and between-session habituation of cue reactivity, as well as a reduction in attentional bias to alcohol cues over time was found. However, there was no evidence of greater habituation in the DCS group. Subtle stimulant effects (increased subjective contentedness and euphoria) which were unrelated to exposure/response prevention were found following DCS.
  
  
  CONCLUSIONS
  DCS does not appear to enhance habituation of alcohol cue reactivity in heavy non-dependent drinkers. Its utility in enhancing treatments based on exposure/response prevention in dependent drinkers or drug users remains open.
authors: Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E6BT, UK. sunjeev.kamboj@ucl.ac.uk
authors: Sunjeev K
authors: SK
authors: Kamboj
authors: Rachel
authors: R
authors: Massey-Chase
authors: Lydia
authors: L
authors: Rodney
authors: Ravi
authors: R
authors: Das
authors: Basil
authors: B
authors: Almahdi
authors: H Valerie
authors: HV
authors: Curran
authors: Celia J A
authors: CJ
authors: Morgan
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects; D000368:Aged; D000428:Alcohol Drinking / Q000517:prevention & control / Q000523:psychology; D001288:Attention / Q000187:drug effects*; D003463:Cues; D003523:Cycloserine / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005108:Extinction, Psychological / Q000187:drug effects; D005260:Female; D006185:Habituation, Psychophysiologic / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D025341:Principal Component Analysis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003523:Cycloserine