Cognitive Enhancement and Relapse Prevention in Cocaine Addiction
Condition: Cocaine Addiction
MeSH terms: Cocaine-Related Disorders; Behavior, Addictive
Study type: Interventional

Summary: 
      For this project, the investigators are interested in exploring a new way to extend and
      maintain drug abstinence in people who are addicted to crack cocaine. This study will combine
      a medication called D-Cycloserine (DCS) and weekly cognitive behavioral therapy (CBT) to
      assess whether the combination will enhance people's ability to stay clean (drug free) for
      longer periods of time.

      One of the greatest risks for drug relapse is drug craving. Oftentimes drug craving occurs
      when a person is confronted with stressors and reminders of past drug use behavior. DCS has
      been shown to enhance the learning of new information. By administering DCS prior to learning
      new techniques such as how to cope with drug craving and drug-use reminders, it is possible
      that patients can be more successful at living a drug free life for a longer period of time.

      In addition to exploring this model behaviorally, the investigators will explore changes that
      may occur in the brain before and after the therapy/medication intervention. A technique
      called MRI (Magnetic Resonance Imaging) will be used to identify areas of the brain that are
      being activated during an attention task. Areas of neural activation will be assessed at
      study entry, end of therapy (4-week endpoint) and one month following completion of the
      treatment program.
    

Detailed description: 
      Primary Hypothesis:

      Enhancing glutamatergic neurotransmission with DCS facilitates CBT-related relapse prevention
      by potentiating the behavioral and neural representation of the diminished drug motivation
      associated with cocaine cues.

      Specific Aims:

        1. Determine if the short-term oral administration of DCS relative to placebo prior to CBT
           sessions facilitates cocaine abstinence and functional recovery, and reduces cocaine
           craving in treatment-seeking cocaine addicts.

        2. Determine if DCS administration relative to placebo facilitates CBT-related decreases in
           the behavioral and neural response to conditioned cocaine cues.
    

Intervention name(s): Seromycin (D-cycloserine, DCS); Placebo; Computerized Cognitive Behavioral Therapy
Intervention type(s): Drug; Drug; Behavioral
Intervention description(s): 250 mg DCS once weekly for 4 weeks prior to the initiation of a Computerized Cognitive Behavioral Therapy (CBT) session for drug relapse intervention.; Placebo identical looking to the 250 mg DCS once weekly for 4 weeks prior to the initiation of a Computerized Cognitive Behavioral Therapy (CBT) session for drug relapse intervention.; All participants received Computerized Cognitive Behavioral Therapy sessions 3 times per week for 4 weeks as a drug relapse intervention.
Other intervention name(s): D-cycloserine, DCS
Intervention MeSH terms: Cycloserine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: cocaine dependence; relapse prevention; computerized cognitive behavioral therapy (CBT); D-cycloserine (DCS)