Table 1.
Clinical Literature on DCS-Coupled CET for Addiction
| Participants | CET Protocol | Groupsa | Time of DCS Admin |
|---|---|---|---|
| Nicotine | |||
| Men and women; ages 18–55 yrs; smoked at least 10 cigarettes/day for previous yr; smoked ~24 yrs on average; not taking measures to quit; abstained for at least 11 hours before CET sessions; instructed to abstain for at least 4 hours after CET sessions | Handling cigarettes, ashtrays, and lighters | DCS 50 mg (n = 8), placebo (n = 10) | 1 hour pre-CET sessions |
| Men and women; ages 18–65 yrs; smoked at least 15 cigarettes/day; nicotine-dependent; not taking measures to quit; abstained for 2 hours before CET sessions; instructed to abstain for 2 hours after CET sessions | Imagining craving scenarios; handling cigarettes and lighters; video depicting a man smoking | DCS 125 mg (n = 13), placebo (n = 13) | ~1 hour pre-CET sessions |
| Cocaine | |||
| Men and women; at least 18 yrs old; met DSM-IV criteria for cocaine dependence; nontreatment-seeking; abstinent for at least 24 hours before all sessions | Handling paraphernalia, simulated cocaine, and money; video depicting cocaine use | DCS 50 mg (n = 5), placebo (n = 5) | 2 hours pre-CET sessions |
| Alcohol | |||
| Men and women; ages 18–65 yrs; heavy drinkers; nontreatment-seeking; did not meet criteria for alcohol dependence; abstinent for at least 12 hours before all sessions | Imaginal cues; handling and smelling favored alcoholic drink | DCS 125 mg (n = 19), placebo (n = 17) | 1 hour pre-CET sessions |
| Men and women; >18 yrs old; DSM-IV diagnosis of alcohol dependence; in treatment (inpatient or outpatient); abstinent for minimum of 2 weeks; experiencing alcohol craving | Graded CET: seeing a picture of favored drink; seeing a bottle or can of favored drink; opening drink; pouring drink and raising to lips without sipping | DCS 250 mg (n = 7), placebo (n = 7) | 2 hours pre-CET sessions 1 and 2 |
| Men ages 21–50 yrs; heavy drinkers; nontreatment-seeking; instructed to remain abstinent for study period; exhibited craving to alcohol cues at intake | Seeing a glass of favored drink; handling drink; smelling drink; imaginal cues | DCS 50 mg (n = 10), placebo (n = 10) | 1 hour pre-CET sessions 1–3 |
| Measurement Time Point | Measure | DCS Effect | Reference |
|---|---|---|---|
| CET session 1 (week 1) | Skin conductance | NE | Santa Ana et al. (34) |
| Cue-induced urge to smoke | Facilitated extinction | ||
| Follow-up 1 (week 2) | Number of cigarettes smoked | NE | |
| Smoking urges questionnaire | NE | ||
| Urinary drug screen (cotinine) | NE | ||
| Expired CO | Reduced | ||
| CET session 2 (week 3) | Skin conductance | Facilitated extinction | |
| Cue-induced urge to smoke | Facilitated extinction | ||
| Follow-up 2 (week 4) | Number of cigarettes smoked | NE | |
| Smoking urges questionnaire | NE | ||
| Urinary drug screen (cotinine) | NE | ||
| Expired CO | Reduced (trend) | ||
| CET session 1 | Attentional bias task | NE | Kamboj et al. (35) |
| Mood and bodily symptoms (baseline) | Decreased euphoria (trend) | ||
| Tonic craving (baseline) | NE | ||
| Episodic craving (CET) | NE | ||
| Skin conductance (CET) | NE | ||
| CET session 2 | Tonic craving (baseline) | NE | |
| Episodic craving (CET) | NE | ||
| Skin conductance (CET) | NE | ||
| First follow-up (2–3 days after CET session 2) | Attentional bias task | NE | |
| Tonic craving | NE | ||
| Second follow-up (by telephone; 14 days after first follow-up) | Number of cigarettes smoked | NE | |
| Tonic craving | Reduced emotionality (trend) | ||
| Time since last cigarette | NE | ||
| CET session 1 (day 1) | Craving (baseline) | NE | Price et al. (47) |
| HR (baseline) | NE | ||
| Craving (CET) | Increased (trend) | ||
| HR (CET) | NE | ||
| CET session 2 (day 2) | Craving (baseline) | NE | |
| HR (baseline) | NE | ||
| Craving (CET) | NE | ||
| HR (CET) | NE | ||
| One week follow-up | Craving | NE | |
| Cocaine use | NE | ||
| CET sessions 1 and 2: postplacebo or -DCS (baseline) | Craving, mood, bodily symptoms | Increased contentedness and trend toward increased euphoria | Kamboj et al. (36) |
| CET sessions 1 and 2: during/after CET | Craving | NE | |
| Skin conductance | NE | ||
| Alcohol consumed in past 2 days | NE | ||
| Follow-up | Alcohol consumed in past 2 days | NE | |
| Attentional bias task | NE | ||
| CET sessions 1 and 2 and follow-up | Craving | NE | Watson et al. (50) |
| Physiological resp (BP, HR) | NE | ||
| Mood states | NE | ||
| CET sessions 1–3 (days 1, 4, and 8) | Craving | NE | Hofmann et al. (51) |
| HR | NE | ||
| Test session 1 (day 11) | Craving | Increasedb | |
| HR | NE | ||
| Test session 2 (day 15) | Craving | NE | |
| HR | NE | ||
Bold text indicates facilitation of extinction or reduction of conditioned response (CR) recovery. Unhighlighted text indicates no effect.
Admin, administration; BP, blood pressure; CET, cue exposure therapy; CO, carbon monoxide; DCS, D-cycloserine; HR, heart rate; NE, no effect; resp, response.
a
Numbers indicate number of participants finishing all phases of study.
b
Statistically significant with some statistical tests but not others.