Effects of divalproex on smoking cue reactivity and cessation outcomes among
smokers achieving initial abstinence.
Author(s): Ditre JW, Oliver JA, Myrick H, Henderson S, Saladin ME, Drobes DJ.
Affiliation(s): Department of Psychology, Texas A&M University, TX, USA.
Publication date & source: 2012, Exp Clin Psychopharmacol. , 20(4):293-301
Divalproex, a GABA agonist, may be a useful agent in the treatment of tobacco
dependence. Cue reactivity assessment paradigms are ideally suited to explore
basic mechanisms underlying the pharmacological effects of medications that
purport to have efficacy for smoking cessation. Our primary goal in the current
study was to examine the effects of divalproex on in-treatment reactivity to
smoking-relevant and affective cues, and to determine if these reactions were
predictive of posttreatment smoking behavior. There were 120 nicotine dependent
smokers enrolled in an 8-week double-blind clinical trial and randomly assigned
to either divalproex or placebo conditions. Of these, 72 smokers (60% female) who
achieved a minimal level of abstinence underwent an in-treatment cue reactivity
assessment. Contrary to expectations, divalproex was associated with greater
craving and arousal during smoking cue presentation. Divalproex also inhibited
cardiovascular response to pleasant cues. Although no significant differences in
cessation-related outcomes between divalproex- and placebo-treated participants
were observed, cue-elicited craving to smoke predicted end-of-treatment and
posttreatment smoking rates. These findings suggest that in-treatment cue
reactivity assessment may proactively and dynamically inform ongoing treatment as
well as provide a tool for screening potential medications for smoking cessation.
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