A controlled trial of the adjunct use of D-Cycloserine to facilitate cognitive behavioral therapy outcomes in a cocaine-dependent population

• Type of Material: Article
• Authors: Ashley P. Kennedy, Emory University; Robin E. Gross, Emory University; Natasha Nicole Whitfield, Emory University; Karen Drexler, Emory University; Clinton D. Kilts, Emory University
• Language: English
• Date: 2012-08-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 Elsevier Ltd.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.addbeh.2012.03.008
• Title of Journal or Parent Work: Addictive Behaviors
• ISSN: 0306-4603
• Volume: 37
• Issue: 8
• Start Page: 900
• End Page: 907
• Grant/Funding Information: This project was supported by NIH grants R21DA025243 and F31DA025491 from the National Institutes of Drug Abuse (NIDA), and the National Center for Research Resources grants UL RR025008 and TL1 RR025010 from the Atlanta Clinical and Translational Science Institute (ACTSI).; These funding sources had no direct role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the study description for publication.
• Keywords: D-Cycloserine; CONDITIONED PLACE PREFERENCE; SYNAPTIC PLASTICITY; Life Sciences & Biomedicine; Addiction; EXPOSURE THERAPY; EXTINCTION; Science & Technology; D-ASPARTATE RECEPTOR; DRUG-SEEKING; Substance Abuse; Clinical trial; OBSESSIVE-COMPULSIVE DISORDER; Psychology; Cognitive behavioral therapy; ADDICTION; Memory; Cocaine; RANDOMIZED-TRIAL; Psychology, Clinical; FOLLOW-UP; Social Sciences
• Research Categories: Psychology, Behavioral; Psychology, Clinical; Health Sciences, General

Abstract

Cocaine dependence is a chronically relapsing disorder for which its predominant behavioral therapies are associated with only partial efficacy. The goal of this study was to determine if the N-methyl- d-aspartate (NMDA) glutamate receptor partial agonist and cognitive enhancer, d-cycloserine (DCS), could boost the cocaine abstinence and treatment retention goals of cognitive behavioral therapy (CBT). This study employed a placebo-controlled, randomized double-blind trial design of 44 cocaine-dependent men enrolled in a 4-week outpatient Substance Abuse Treatment Program (SATP) at the Atlanta Veteran's Administration Medical Center. Subjects received 50. mg of DCS or placebo prior to four weekly sessions of a condensed version of a manual-based CBT for cocaine dependence. Cocaine abstinence and treatment retention measures represented primary outcome variables. Relative to a 12-step based treatment-as-usual, an under-dosed CBT was associated with significant improvements in drug abstinence and treatment retention at 4-weeks and for maintenance of drug abstinence after four more weeks of follow-up. The robust response to the under-dosed CBT was not enhanced by the adjunct administration of DCS at either the 4- or 8-week endpoints. This controlled clinical trial failed to demonstrate an ability of DCS to boost the relapse prevention or treatment retention goals of CBT.