Investigation of Cycloserine as a Smoking Cessation Treatment

Psychosocial treatments for drug abuse benefit some patients (Rawson et al 2004), but there
is an urgent need for new treatment approaches that can improve treatment outcomes. One new
approach involves facilitation of extinction of conditioned responses through the use of
d-cycloserine, a partial agonist at the NMDA glycine site. This approach has proved useful
for the treatment of several anxiety disorders. For example, treatment with d-cycloserine
enhanced the efficacy of behavioral treatments for acrophobia (Ressler et al 2004) and
social phobia (Hofmann et al 2006) by enhancing extinction of conditioned fear responses.
This suggests that d-cycloserine has potential to enhance the efficacy of behavioral
treatments for drug dependence by enhancing extinction of conditioned responses to drug
cues. In this Phase I Cutting-Edge Basic Research Awards (CEBRA) application we propose a
proof-of-concept study to examine effects of treatment with d-cycloserine for facilitating
extinction of craving provoked by exposure to cigarette smoking cues. The benefits of this
treatment approach together with cognitive behavioral treatment for reducing cigarette
smoking will then be determined. Smoking cues will be presented using an established virtual
reality simulator(Bordnick et al 2004; Bordnick et al 2005a)