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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

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Abstract

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.

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Acknowledgments

This research was supported by NIDA grant R21DA025155 (Saladin, PI) and by the South Carolina Clinical & Translational Research (SCTR) Institute, with an academic home at the Medical University of South Carolina, through NIH Grant Numbers UL1 RR029882 and UL1 TR000062. The authors report no conflicts of interest pertaining to this study.

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Authors and Affiliations

  1. Department of Health Sciences and Research, Medical University of South Carolina (MUSC), Charleston, SC, USA

    Michael E. Saladin

  2. Clinical Neuroscience Division, MUSC, Charleston, SC, USA

    Michael E. Saladin, Kevin M. Gray, Aimee L. McRae-Clark, Steven D. LaRowe, Sharon D. Yeatts, Nathaniel L. Baker, Karen J. Hartwell & Kathleen T. Brady

  3. Youth Division, Department of Psychiatry and Behavioral Sciences (MUSC), Charleston, SC, USA

    Kevin M. Gray

  4. Division of Biostatistics and Epidemiology (MUSC), Charleston, SC, USA

    Sharon D. Yeatts & Nathaniel L. Baker

  5. Substance Abuse Treatment Center, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA

    Steven D. LaRowe

  6. Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, 77 President St., Room 224, MSC700, Charleston, SC, 29425, USA

    Michael E. Saladin

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  1. Michael E. Saladin
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Saladin, M.E., Gray, K.M., McRae-Clark, A.L. et al. 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. Psychopharmacology 226, 721–737 (2013). https://doi.org/10.1007/s00213-013-3039-3

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