D-cycloserine, an antibiotic commonly used to treat tuberculosis, has been shown to act as a learning and memory enhancer when administered in low doses. In a new study, published in April’s Translational Psychiatry, combining D-cycloserine with behavioral therapy decreased cravings for alcohol in people with AUD after just one dose. The reduction in cravings lasted for up to three weeks. While the effects were not long-lasting, the study demonstrated that the value of a medication like D-cycloserine may lie in its ability to speed up and enhance new learning, potentially improving the outcomes of psychological treatment.
“Most existing medications used to treat addictions either replace the drug in a less addictive form to minimize withdrawal, such as nicotine replacement therapy and methadone, or alter the effects of the drug, such as naltrexone,” said lead author Dr. James MacKillop, Director of the Peter Boris Centre for Addictions Research at St. Joseph’s Healthcare Hamilton in Hamilton, Ontario. “This approach is qualitatively different – and demonstrates that a learning-enhancement medication has the potential of enhancing behavioral treatment for alcohol use disorders.”
The study used a translational approach, incorporating laboratory science with clinical research. Part of the treatment was done in a simulated real-life setting, a bar laboratory at the University of Georgia, where participants received either a placebo or the medication and were exposed to alcohol and alcohol-related environmental triggers while receiving motivational enhancement therapy, labeled “self-control training.” The group who took the medication during treatment had fewer cravings.
“Cravings for alcohol are often produced by environmental triggers – such as people, places and the sight of alcohol itself,” explained Dr. MacKillop. “Our attempts to reduce these cravings in treatment haven’t been very successful. In this study, however, patients receiving the medication exhibited a steeper reduction of cravings in the presence of alcohol triggers. Moreover, this reduction persisted over time, resulting in very low absolute levels of craving.”
In the scientific paper, the researchers acknowledge that these findings may not fully translate to real-world situations but believe the results are promising enough to warrant further research.