A double blind, placebo-controlled study of the effects of post-retrieval propranolol on reconsolidation of memory for craving and cue reactivity in cocaine dependent humans

• Published in: Psychopharmacology Vol. 226; no. 4; pp. 721 - 737
• Main Authors: Saladin, Michael E., Gray, Kevin M., McRae-Clark, Aimee L., LaRowe, Steven D., Yeatts, Sharon D., Baker, Nathaniel L., Hartwell, Karen J., Brady, Kathleen T.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.04.2013; Springer Nature B.V
• Subjects: Adrenergic beta-Antagonists - pharmacology; Adult; Beta blockers; Biomedical and Life Sciences; Biomedicine; Cocaine; Cocaine-Related Disorders - drug therapy; Cocaine-Related Disorders - psychology; Cues; Double-Blind Method; Drug addiction; Female; Follow-Up Studies; Humans; Male; Memory; Memory - drug effects; Neurosciences; Original Investigation; Pharmacology/Toxicology; Propranolol - pharmacology; Psychiatry; Time Factors; Retrieval; Cocaine dependence; Human subjects; Reconsolidation; Cue exposure; Craving
• ISSN: 0033-3158; 1432-2072; 1432-2072
• DOI: 10.1007/s00213-013-3039-3

Rationale/objectives This study examined the effects of propranolol vs. placebo, administered immediately after a “retrieval” session of cocaine cue exposure (CCE), on craving and physiological responses occurring 24 h later during a subsequent “test” session of CCE. It was hypothesized that compared to placebo-treated cocaine-dependent (CD) individuals, propranolol-treated CD individuals would evidence attenuated craving and physiological reactivity during the test session. Secondarily, it was expected that group differences identified in the test session would be evident at a 1-week follow-up CCE session. Exploratory analyses of treatment effects on cocaine use were also performed at follow-up. Methods CD participants received either 40 mg propranolol or placebo immediately following a “retrieval” CCE session. The next day, participants received a “test” session of CCE that was identical to the “retrieval” session except no medication was administered. Participants underwent a “follow-up” CCE session 1 week later. Craving and other reactivity measures were obtained at multiple time points during the CCE sessions. Results Propranolol- vs. placebo-treated participants evidenced significantly greater attenuation of craving and cardiovascular reactivity during the test session. Analysis of the follow-up CCE session data did not reveal any group differences. Although there was no evidence of treatment effects on cocaine use during follow-up, this study was insufficiently powered to rigorously evaluate differential cocaine use. Conclusions This double-blind, placebo-controlled laboratory study provides the first evidence that propranolol administration following CCE may modulate memories for learning processes that subserve cocaine craving/cue reactivity in CD humans. Alternative interpretations of the findings were considered, and implications of the results for treatment were noted.