D-cycloserine may help decrease alcohol cravings

By Rob Goodier

NEW YORK (Reuters Health) - Adding D-cycloserine to behavioral therapy for alcoholism decreases cravings after just one session, a new study has found.

"This work suggests that in the future, physicians treating alcoholism may not think about medications and behavioral treatments as being different strategies, but that we may use medications to improve behavioral treatment directly," James MacKillop of McMaster University in Hamilton, Ontario, Canada, who led the study, told Reuters Health by email.

In a report online April 7 in Translational Psychiatry, MacKillop and his colleagues explain that D-cycloserine is an antibiotic used to treat drug-resistant strains of tuberculosis. It also acts on the brain as a partial agonist of the NMDA glutamatergic receptor, which is important in learning and memory.

Past research has shown that D-cycloserine enhances behavioral therapies for anxiety disorders, including phobias, panic attacks, obsessive-compulsive disorder, and social anxiety. The drug has also reduced alcohol craving behaviors in mice and rats.

In a double-blinded study, MacKillop and his team randomized 37 alcoholics to receive capsules with D-cycloserine at 50 mg or a placebo one hour before exposure to alcohol in a simulated bar environment.

Thirty completed the treatment, which included four sessions of motivational enhancement therapy over a two-week period, with a follow up at three weeks.

The drug or placebo were administered at the first and third sessions, which were one week apart and included exposure therapy. During exposure, the participants alternated between observing their drink of choice and interacting with it without actually tasting it.

The D-cycloserine group reported significantly lower cravings from the first session and the reduction remained significant through the final follow up.

That group also drank less during treatment, but the difference in drinking was not significant at the time of follow up. That may be in part because the study was not large enough to test for drinking outcomes or different doses or treatment regimens, MacKillop said.

"Instead," he added, "the focus of this study was to zero in on the effects in lab to see if the medication has promise for larger scale study. Future strategies to amplify this effect also include increasing the number of medication administrations, as two was the minimum number to expect to see an effect."


Transl Psychiatry 2015.

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