Effects of D-cycloserine on cue-induced craving and cigarette smoking among concurrent cocaine- and nicotine-dependent volunteers

Addict Behav. 2013 Feb;38(2):1518-1526. doi: 10.1016/j.addbeh.2012.03.022. Epub 2012 Mar 26.


Rates of cigarette smoking are 3- to 4-fold greater among those with cocaine-dependence, and compared to non-users, cocaine users are at greater risk of incurring smoking-related negative health effects and death. The current study examined D-cycloserine's (0 or 50mg once weekly) effects on 1) extinction of cue-induced craving for cigarettes, 2) cigarette smoking in conjunction with cognitive-behavioral therapy, and 3) safety and tolerability in cocaine-dependent smokers. This was a double-blind, placebo-controlled, between groups, outpatient study. Participants (N=29) were concurrent cocaine- and nicotine-dependent volunteers seeking treatment for their cigarette smoking. Study visits were 3 times per week for 4 consecutive weeks. At each visit, participants received cognitive-behavioral therapy for smoking, were exposed to smoking cues. A subset of participants (N=22) returned for 6-month follow-up visits. While craving decreased, no significant effects of D-cycloserine treatment were observed. Likewise, significant decreases in smoking were observed at study days 6 (p<0.002) and 12 (p<0.0001) relative to baseline, although no participants achieved complete abstinence. However, there was no effect of D-cycloserine on cigarette smoking during treatment or at 6-mos follow-up. The treatment was safe and tolerable, with nearly 90% of treatment sessions attended based on an intent-to-treat analysis. While no effects of D-cycloserine on craving or smoking were observed in the current study, the results do suggest that smoking treatment is well accepted and may be effective for cocaine-dependent individuals.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Breath Tests
  • Cocaine-Related Disorders / complications
  • Cocaine-Related Disorders / drug therapy*
  • Cocaine-Related Disorders / psychology
  • Cognitive Behavioral Therapy / methods
  • Combined Modality Therapy / methods
  • Cues*
  • Cycloserine / pharmacology
  • Cycloserine / therapeutic use*
  • Double-Blind Method
  • Extinction, Psychological / drug effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Implosive Therapy / methods
  • Intention to Treat Analysis
  • Male
  • Middle Aged
  • Placebos
  • Receptors, N-Methyl-D-Aspartate / agonists
  • Secondary Prevention
  • Self Report
  • Smoking / drug therapy*
  • Smoking / psychology
  • Smoking Cessation / methods
  • Tobacco Use Disorder / complications
  • Tobacco Use Disorder / drug therapy*
  • Tobacco Use Disorder / psychology
  • Treatment Outcome
  • Young Adult


  • Placebos
  • Receptors, N-Methyl-D-Aspartate
  • Cycloserine