Psychopharmacology

, Volume 221, Issue 2, pp 273–284

Cue exposure and response prevention with heavy smokers: a laboratory-based randomised placebo-controlled trial examining the effects of D-cycloserine on cue reactivity and attentional bias

  • Sunjeev K. Kamboj
  • Alyssa Joye
  • Ravi K. Das
  • Andrew J. W. Gibson
  • Celia J. A. Morgan
  • H. Valerie Curran
Original Investigation

DOI: 10.1007/s00213-011-2571-2

Cite this article as:
Kamboj, S.K., Joye, A., Das, R.K. et al. Psychopharmacology (2012) 221: 273. doi:10.1007/s00213-011-2571-2

Abstract

Rationale

Treatments based on exposure/response prevention (Exp/RP) produce only modest benefits in substance dependence disorders. However, a new strategy, which has shown promise in animal models of addiction involves combining Exp/RP with extinction-enhancing pharmacological treatments. A prototype of the latter is D-cycloserine (DCS), a partial agonist at the glycine site of the NMDA receptor.

Methods

In a laboratory-based randomised, double-blind, placebo-controlled trial with non-treatment-seeking heavy smokers (n = 32), we examined the efficacy of Exp/RP combined with DCS (125 mg). Two sessions of Exp/RP were carried out during which cue reactivity was monitored. Effects on attentional bias and/or subjective craving and smoking behaviour were also evaluated after at least 48 h and 2 weeks following session 2 of Exp/RP.

Results

Within- and between-session reductions in cue reactivity were observed in both treatment groups, although the DCS group did not show an enhanced reduction by the end of session 2. However, a subtle effect of DCS on the emotionality subscale of the Tobacco Craving Questionnaire was observed, with a trend towards a sustained reduction in this aspect of craving at 2-week follow-up.

Conclusion

Our findings suggest that two sessions of Exp/RP combined with DCS does not enhance the reduction in episodic cue reactivity in non-treatment seeking smokers. A trend towards a greater sustained reduction in the emotionality scale of the TCQ in the DCS group suggests that further detailed study of the effects of combined Exp/RP-DCS on different aspects of craving is warranted, especially in smokers with a current intention to quit.

Keywords

Nicotine Substance dependence Cue exposure Response prevention D-cycloserine Cue reactivity Attentional bias Habituation Extinction 

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Sunjeev K. Kamboj
    • 1
  • Alyssa Joye
    • 1
  • Ravi K. Das
    • 1
  • Andrew J. W. Gibson
    • 1
  • Celia J. A. Morgan
    • 1
  • H. Valerie Curran
    • 1
  1. 1.Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK