Effectiveness of propranolol for cocaine dependence treatment may depend on cocaine withdrawal symptom severity

Kampman, Kyle M.; Volpicelli, Joseph R.; Mulvaney, Frank D.; Alterman, Arthur I.; Cornish, James; Gariti, Peter; Cnaan, Avital; Poole, Sabrina; Muller, Eric; Acosta, Thalia; Luce, Douglas D.; O’Brien, Charles P.

doi:10.1016/s0376-8716(00)00193-9

Cited by 122 publications

(74 citation statements)

References 35 publications

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“…Propranolol has also shown promise in animals in reducing avoidance conditioning, 16 fear conditioning 14 and craving related to cocaine and nicotine dependence. 57,58 In humans, Reist and colleagues 27 replicated the paradigm by Cahill and colleagues 11 in both a healthy population and a clinical (PTSD) sample, finding no between-group differences. Although the study by Reist and colleagues did not involve deeply ingrained traumatic memories, propranolol dampened memory enhancement for an emotionally upsetting slide story in both the healthy and clinical populations.…”

Section: Can Propranolol Effectively Block Memory Consolidation or Rementioning

confidence: 56%

Propranolol’s effects on the consolidation and reconsolidation of long-term emotional memory in healthy participants: a meta-analysis

Lonergan

Olivera-Figueroa

Pitman

et al. 2013

J Psychiatry Neurosci

178

127

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Section: Can Propranolol Effectively Block Memory Consolidation or Rementioning

confidence: 56%

Propranolol’s effects on the consolidation and reconsolidation of long-term emotional memory in healthy participants: a meta-analysis

Lonergan

Olivera-Figueroa

Pitman

et al. 2013

J Psychiatry Neurosci

178

127

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“…Stress and cue-related increases in heart rate and blood pressure have been observed alongside increases in cocaine craving within recently abstinent cocaine abusers in several studies (Back et al, 2005;Sinha et al, 2001Sinha et al, , 2003Fox et al, 2005Fox et al, , 2006. b-Adrenergic blockade by drugs such as propranolol have also been shown to reduce the symptoms of autonomic arousal associated with early cocaine abstinence and improve treatment outcome (Kampman et al, 2001b(Kampman et al, , 2006. It may therefore be the case that increased heart rate and blood pressure represent a non-specific physiological marker of stress-and cue-induced craving state that may be elevated during cocaine abstinence.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Emotional and Physiological Sensitivity to Stress and Drug/Alcohol Craving in Abstinent Cocaine-Dependent Individuals Compared to Socially Drinking Controls

Fox

Hong

Siedlarz

et al. 2007

Neuropsychopharmacology

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Chronic exposure to cocaine is associated with neuroadaptions in stress and reward circuits that may increase susceptibility to relapse. We examined whether there are alterations in stress response and craving in abstinent cocaine-dependent individuals compared with a demographically matched group of non-addicted socially drinking community controls. Forty treatment-engaged abstinent cocaine patients (17F/23M) and 40 controls (19F/21M) were exposed to a brief 5 min guided imagery of individually calibrated stressful situations, personal drug/alcohol-related situation and a neutral-relaxing situation, one imagery per session, presented in random order. Craving, anxiety, emotion rating scales, and physiological measures were assessed. Cocaine patients reported significantly higher and more persistent stress-and cue-induced drug/alcohol craving, negative emotions, and physiological responses compared with social drinkers. In cocaine patients, stress-and cue-induced drug craving was accompanied by increased anger, fear, sadness, heart rate, and SBP. Controls reported minimal stress-induced craving and only increases in anxiety and SBP during stress exposure. Cue-induced alcohol craving was accompanied only by an increase in relaxed state. Females reported increased stress-induced anxiety and sadness compared with males, while males were emotionally and physiologically more reactive in the cue condition. These findings are the first to document functional alterations in stress-and reward-related affect and physiology in recently abstinent cocaine patients that is marked by an enhanced sensitivity to stress-and drug-related cue exposure. These data suggest that recovery from chronic cocaine abuse could be hampered by a hyper-responsive stress-and drug-craving state that increases cocaine relapse susceptibility.

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“…Preventing retrieval of these associative memories, through targeted dHipp b-AR blockade, would therefore limit relapse susceptibility. Clinical studies have demonstrated that treating human addicts with the non-selective NE inhibitor disulfiram (Carroll et al, 1998) or b-AR antagonist propranolol (Kampman et al, 2001; enhances treatment retention. The improved retention could be due to disruption of drug-associated memory retrieval or reconsolidation.…”

Section: Discussionmentioning

confidence: 99%

Inhibition of Hippocampal β-Adrenergic Receptors Impairs Retrieval But Not Reconsolidation of Cocaine-Associated Memory and Prevents Subsequent Reinstatement

Otis

Fitzgerald

Mueller

2013

Neuropsychopharmacol

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Retrieval of drug-associated memories is critical for maintaining addictive behaviors, as presentation of drug-associated cues can elicit drug seeking and relapse. Recently, we and others have demonstrated that b-adrenergic receptor (b-AR) activation is necessary for retrieval using both rat and human memory models. Importantly, blocking retrieval with b-AR antagonists persistently impairs retrieval and provides protection against subsequent reinstatement. However, the neural locus at which b-ARs are required for maintaining retrieval and subsequent reinstatement is unclear. Here, we investigated the necessity of dorsal hippocampus (dHipp) b-ARs for drugassociated memory retrieval. Using a cocaine conditioned place preference (CPP) model, we demonstrate that local dHipp b-AR blockade before a CPP test prevents CPP expression shortly and long after treatment, indicating that dHipp b-AR blockade induces a memory retrieval disruption. Furthermore, this retrieval disruption provides long-lasting protection against cocaine-induced reinstatement. The effects of b-AR blockade were dependent on memory reactivation and were not attributable to reconsolidation disruption as blockade of b-ARs immediately after a CPP test had little effect on subsequent CPP expression. Thus, cocaine-associated memory retrieval is mediated by b-AR activity within the dHipp, and disruption of this activity could prevent cue-induced drug seeking and relapse long after treatment.

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Effectiveness of propranolol for cocaine dependence treatment may depend on cocaine withdrawal symptom severity

Cited by 122 publications

References 35 publications

Propranolol’s effects on the consolidation and reconsolidation of long-term emotional memory in healthy participants: a meta-analysis

Propranolol’s effects on the consolidation and reconsolidation of long-term emotional memory in healthy participants: a meta-analysis

Enhanced Emotional and Physiological Sensitivity to Stress and Drug/Alcohol Craving in Abstinent Cocaine-Dependent Individuals Compared to Socially Drinking Controls

Inhibition of Hippocampal β-Adrenergic Receptors Impairs Retrieval But Not Reconsolidation of Cocaine-Associated Memory and Prevents Subsequent Reinstatement

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