A placebo-controlled randomized trial of D-cycloserine augmentation of cue exposure therapy for smoking cessation
| Autor: | Gladys N. Pachas, Susanne S. Hoeppner, Heather Burrell Ward, Corinne Cather, Bridget A. Hearon, Jasper A. J. Smits, Alexandra B Laffer, Michael W. Otto, A. Eden Evins, Samantha J. Moshier |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment media_common.quotation_subject Implosive Therapy Craving Placebo Article law.invention 03 medical and health sciences Young Adult 0302 clinical medicine Randomized controlled trial Double-Blind Method law Internal medicine medicine Humans media_common Aged business.industry Addiction Smoking Extinction (psychology) Abstinence Middle Aged Combined Modality Therapy 030227 psychiatry Clinical Psychology Treatment Outcome Cue reactivity Cycloserine Smoking cessation Female Smoking Cessation Self Report medicine.symptom Cues business 030217 neurology & neurosurgery |
| Zdroj: | Cognitive behaviour therapy. 48(1) |
| ISSN: | 1651-2316 |
| Popis: | BACKGROUND: Despite encouraging evidence from pre-clinical studies, clinical trials of d-cycloserine (DCS) augmentation of cue exposure treatment (CET) for substance use disorders have been disappointing. Recent studies underscore the importance of studying DCS under conditions of adequate cue exposure and protection from reconditioning experiences. In this randomized trial, we evaluated the efficacy of DCS for augmenting CET for smoking cessation under these conditions. METHODS: Sixty-two smokers attained at least 18 hours abstinence following 4 weeks of cognitive-behavioral treatment combined with varenicline or nicotine replacement therapy and were randomly assigned to receive a single dose of DCS (n=30) or placebo (n=32) prior to each of two sessions of CET. Mechanistic outcomes were self-reported cravings and physiologic reactivity to smoking cues. The primary clinical outcome was 6-week, biochemically-verified, continuous tobacco abstinence. RESULTS: We found that DCS, relative to placebo, augmentation of CET resulted in lower self-reported craving to smoking pictorial and in vivo cues (d = 0.8 to 1.21) in a relevant subsample of participants who were reactive to cues and free from smoking-related reconditioning experiences. Select craving outcomes were also significantly related to smoking outcomes, and overall, DCS augmentation was associated with a trend toward a higher continuous abstinence rate (33% vs. 13%) compared to those who received placebo and CET. CONCLUSIONS: DCS augmentation of CET can significantly reduce cue-induced craving, and such reductions in craving are meaningfully related to smoking cessation outcomes, supporting the therapeutic potential of DCS augmentation when applied under appropriate conditions for adequate extinction learning and retention. CLINICAL TRIAL REGISTRY: NCT01399866; https://clinicaltrials.gov/ct2/show/results/NCT01399866 |
| Databáze: | OpenAIRE |
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