D-Cycloserine and Cocaine Cue Reactivity: Preliminary Findings

Abstract

Background-D-cycloserine (DCS), a partial glutamate NMDA receptor agonist, enhances extinction of conditioned fear responding in rodents and facilitates exposure-based learning in humans with anxiety disorders.

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

“…The finding that DCS produced mild stimulant effects might suggest that it could interfere with exposurebased therapies due to state-dependent learning (Hoffman 2007). Furthermore, subjective stimulation may also increase craving and prime alcohol use, although the stimulant effect found here was not associated with enhanced response activation in our sample, in contrast to an apparent cue-activation effect in cocaine users (Price et al 2009). …”

“…Therefore, examining the subjective effects of DCS in heavy drinkers (independently of exposure/response prevention) was itself a (secondary) aim of this study. Furthermore, given the description of 'response activation' to cues noted by Price et al (2009) in cocainedependent individuals receiving DCS, we also explored the possibility that this occurs in heavy drinkers receiving DCS in the presence of alcohol cues.…”

“…Since Price et al (2009) cocaine cues-it was of interest to determine if there was a similar effect in heavy drinkers in response to alcohol cues. 'Initial activation of craving' responses-the subjective responses to the first in vivo presentation of alcohol compared with baseline craving-are shown in Fig.…”

“…In a recent descriptive study, Price et al (2009) suggest that combined exposure/response prevention-DCS treatment may acutely enhance 'response activation' in cocainedependent individuals. This effect is difficult to reconcile with the extant literature on extinction of CPP with DCS in animal models of cocaine dependence but may point to subjective effects of DCS on craving which are independent of exposure/response prevention and have yet to be fully explored.…”

The Nucleus Accumbens: Mechanisms of Addiction across Drug Classes Reflect the Importance of Glutamate Homeostasis

“…Cue reactivity encompasses objective measures of sympathetic arousal and/or subjective reports of craving, induced by paraphernalia or pictures associated with the abused drug. These small proof-ofconcept trials have shown decreased cue reactivity for nicotine (Santa Ana et al, 2009), no effect compared with placebo for nicotine (Kamboj et al, 2012;Yoon et al, 2013) and alcohol (Kamboj et al, 2011;Watson et al, 2011), or increased cue reactivity for cocaine (Price et al, 2009(Price et al, , 2013 and alcohol (Hofmann et al, 2012). One study that investigated clinically meaningful outcomes of D-cycloserine for augmenting cueexposure therapy found negative results for nicotine use (Yoon et al, 2013).…”