title: Reactivating addiction-related memories under propranolol to reduce craving: A pilot randomized controlled trial.
abstract: BACKGROUND
  The reconsolidation blocker propranolol abolishes alcohol and drug-seeking behavior in rodents and attenuates conditioned emotional responses to drug-cues in humans in experimental settings. This suggests a role for its use in the treatment of substance dependence. In this translational pilot study, we explored the feasibility and efficacy of this procedure as an adjunct treatment for addiction. We hypothesized that guided addiction-related memory reactivation under propranolol would significantly attenuate tonic craving, a central element in relapse following addiction treatment.
  
  
  METHODS
  Seventeen treatment-seeking adults diagnosed with substance dependence were randomized to receive double-blind propranolol (n = 9) or placebo (n = 8) on six occasions prior to reading a personalized script detailing a drug-using experience. The primary outcome measure was self-reported craving intensity.
  
  
  RESULTS
  After controlling for baseline craving scores, intent-to-treat analysis revealed a time by group interaction, F(1, 14) = 5.68, p = .03, η(2) = 0.29; craving was reduced in the propranolol-treated group (Cohen's d = 1.40, p < .05) but not in the placebo group (d = 0.06, n.s.).
  
  
  CONCLUSIONS
  The usual limitations related to small sample size and the lack of a follow-up apply here.
  
  
  CONCLUSIONS
  Drug-related memory reactivation under propranolol can subsequently reduce craving among substance-dependent individuals. Considering the relapse rate among individuals treated for substance dependence, our study highlights the feasibility of, and need for, more comprehensive trials of this treatment approach.
authors.affiliation: Research Center of the Douglas Mental Health University Institute, 6875 boul. Lasalle, Montreal, Qc, H4H 1R3, Canada; Department of Psychiatry, McGill University, Ludmer Research & Training Bldg., 1033 Pine Ave. West, Montreal, Qc, H3A 1A1, Canada. Electronic address: michelle.lonergan@mail.mcgill.ca.
authors.forename: Michelle
authors.initials: M
authors.lastname: Lonergan
authors.affiliation: Research Center of the Douglas Mental Health University Institute, 6875 boul. Lasalle, Montreal, Qc, H4H 1R3, Canada. Electronic address: saumierd@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Saumier
authors.affiliation: Research Center of the Douglas Mental Health University Institute, 6875 boul. Lasalle, Montreal, Qc, H4H 1R3, Canada; Department of Psychiatry, McGill University, Ludmer Research & Training Bldg., 1033 Pine Ave. West, Montreal, Qc, H3A 1A1, Canada. Electronic address: jacques.tremblay@douglas.mcgill.ca.
authors.forename: Jacques
authors.initials: J
authors.lastname: Tremblay
authors.affiliation: Research Center of the Douglas Mental Health University Institute, 6875 boul. Lasalle, Montreal, Qc, H4H 1R3, Canada; Department of Psychiatry, McGill University, Ludmer Research & Training Bldg., 1033 Pine Ave. West, Montreal, Qc, H3A 1A1, Canada. Electronic address: brigitte.kieffer@douglas.mcgill.ca.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Kieffer
authors.affiliation: Research Center of the Douglas Mental Health University Institute, 6875 boul. Lasalle, Montreal, Qc, H4H 1R3, Canada; Department of Psychiatry, McGill University, Ludmer Research & Training Bldg., 1033 Pine Ave. West, Montreal, Qc, H3A 1A1, Canada. Electronic address: thomas.brown@mcgill.ca.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Brown
authors.affiliation: Research Center of the Douglas Mental Health University Institute, 6875 boul. Lasalle, Montreal, Qc, H4H 1R3, Canada; Department of Psychiatry, McGill University, Ludmer Research & Training Bldg., 1033 Pine Ave. West, Montreal, Qc, H3A 1A1, Canada. Electronic address: alain.brunet@mcgill.ca.
authors.forename: Alain
authors.initials: A
authors.lastname: Brunet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D066249:Craving / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000187:drug effects*; D008875:Middle Aged; D010865:Pilot Projects; D011433:Propranolol / Q000494:pharmacology* / Q000627:therapeutic use*; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000523:psychology*; D055815:Young Adult
chemical_list: D011433:Propranolol
keywords: Clinical trial; Craving; Memory reconsolidation; Propranolol; Substance dependence