The effect of N-acetylcysteine and working memory training on cocaine use, craving and inhibition in regular cocaine users: correspondence of lab assessments and Ecological Momentary Assessment

Mieke H J Schulte, Reinout W Wiers, Wouter J Boendermaker, Anna E Goudriaan, Wim van den Brink, Denise S van Deursen, Malte Friese, Emily Brede, Andrew J Waters

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

INTRODUCTION: Effective treatment for cocaine use disorder should dampen hypersensitive cue-induced motivational processes and/or strengthen executive control. Using a randomized, double-blind, placebo-controlled intervention, the primary aim of this study was to investigate the effect of N-Acetylcysteine (NAC) and working memory (WM)-training to reduce cocaine use and craving and to improve inhibition assessed in the laboratory and during Ecological Momentary Assessment (EMA). The second aim was to examine correspondence between laboratory and EMA data.

METHODS: Twenty-four of 38 cocaine-using men completed a 25-day intervention with 2400mg/day NAC or placebo and WM-training as well as two lab-visits assessing cocaine use, craving and inhibition (Stop Signal task). Additionally, cocaine use, craving and cognition (Stroop task) were assessed using EMA during treatment, with 26 participants completing 819 assessments.

RESULTS: Cocaine problems according to the Drug Use Disorder Identification Test (DUDIT) decreased more after NAC than after placebo, and the proportion of cocaine-positive urines at lab-visit 2 was lower in the NAC group. No NAC effects were found on craving. For cocaine use and craving, results from the lab data were generally similar to EMA results. NAC also showed some effects on cognitive control: improved inhibition assessed with the Stop Signal task in the lab, and decreased classic Stroop performance during EMA. There were no significant effects of number of completed WM-training sessions.

CONCLUSIONS: Overall this study revealed mixed findings regarding the treatment of cocaine use disorders with NAC and WM-training. The effect of NAC on inhibition should be further investigated.

Original languageEnglish
Pages (from-to)24-31
Number of pages8
JournalAddictive Behaviors
Volume79
DOIs
Publication statusPublished - Apr 2018

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Acetylcysteine
Cocaine
Short-Term Memory
Learning
Data storage equipment
Placebos
Ecological Momentary Assessment
Craving
Inhibition (Psychology)
Executive Function
Cognition
Substance-Related Disorders
Cues
Therapeutics
Urine

Keywords

  • Cocaine
  • Craving
  • Inhibition
  • N-acetylcysteine
  • Working memory training
  • Ecological momentary assessment
  • RANDOMIZED CONTROLLED-TRIAL
  • SUBSTANCE USE DISORDERS
  • NICOTINE DEPENDENCE
  • EXECUTIVE FUNCTIONS
  • DRUG-USE
  • QUESTIONNAIRE
  • ADOLESCENTS
  • ADDICTION
  • ABSTINENCE
  • REACTIVITY

Cite this

Schulte, Mieke H J ; Wiers, Reinout W ; Boendermaker, Wouter J ; Goudriaan, Anna E ; van den Brink, Wim ; van Deursen, Denise S ; Friese, Malte ; Brede, Emily ; Waters, Andrew J. / The effect of N-acetylcysteine and working memory training on cocaine use, craving and inhibition in regular cocaine users : correspondence of lab assessments and Ecological Momentary Assessment. In: Addictive Behaviors. 2018 ; Vol. 79. pp. 24-31.
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abstract = "INTRODUCTION: Effective treatment for cocaine use disorder should dampen hypersensitive cue-induced motivational processes and/or strengthen executive control. Using a randomized, double-blind, placebo-controlled intervention, the primary aim of this study was to investigate the effect of N-Acetylcysteine (NAC) and working memory (WM)-training to reduce cocaine use and craving and to improve inhibition assessed in the laboratory and during Ecological Momentary Assessment (EMA). The second aim was to examine correspondence between laboratory and EMA data.METHODS: Twenty-four of 38 cocaine-using men completed a 25-day intervention with 2400mg/day NAC or placebo and WM-training as well as two lab-visits assessing cocaine use, craving and inhibition (Stop Signal task). Additionally, cocaine use, craving and cognition (Stroop task) were assessed using EMA during treatment, with 26 participants completing 819 assessments.RESULTS: Cocaine problems according to the Drug Use Disorder Identification Test (DUDIT) decreased more after NAC than after placebo, and the proportion of cocaine-positive urines at lab-visit 2 was lower in the NAC group. No NAC effects were found on craving. For cocaine use and craving, results from the lab data were generally similar to EMA results. NAC also showed some effects on cognitive control: improved inhibition assessed with the Stop Signal task in the lab, and decreased classic Stroop performance during EMA. There were no significant effects of number of completed WM-training sessions.CONCLUSIONS: Overall this study revealed mixed findings regarding the treatment of cocaine use disorders with NAC and WM-training. The effect of NAC on inhibition should be further investigated.",
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The effect of N-acetylcysteine and working memory training on cocaine use, craving and inhibition in regular cocaine users : correspondence of lab assessments and Ecological Momentary Assessment. / Schulte, Mieke H J; Wiers, Reinout W; Boendermaker, Wouter J; Goudriaan, Anna E; van den Brink, Wim; van Deursen, Denise S; Friese, Malte; Brede, Emily; Waters, Andrew J.

In: Addictive Behaviors, Vol. 79, 04.2018, p. 24-31.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - The effect of N-acetylcysteine and working memory training on cocaine use, craving and inhibition in regular cocaine users

T2 - correspondence of lab assessments and Ecological Momentary Assessment

AU - Schulte, Mieke H J

AU - Wiers, Reinout W

AU - Boendermaker, Wouter J

AU - Goudriaan, Anna E

AU - van den Brink, Wim

AU - van Deursen, Denise S

AU - Friese, Malte

AU - Brede, Emily

AU - Waters, Andrew J

PY - 2018/4

Y1 - 2018/4

N2 - INTRODUCTION: Effective treatment for cocaine use disorder should dampen hypersensitive cue-induced motivational processes and/or strengthen executive control. Using a randomized, double-blind, placebo-controlled intervention, the primary aim of this study was to investigate the effect of N-Acetylcysteine (NAC) and working memory (WM)-training to reduce cocaine use and craving and to improve inhibition assessed in the laboratory and during Ecological Momentary Assessment (EMA). The second aim was to examine correspondence between laboratory and EMA data.METHODS: Twenty-four of 38 cocaine-using men completed a 25-day intervention with 2400mg/day NAC or placebo and WM-training as well as two lab-visits assessing cocaine use, craving and inhibition (Stop Signal task). Additionally, cocaine use, craving and cognition (Stroop task) were assessed using EMA during treatment, with 26 participants completing 819 assessments.RESULTS: Cocaine problems according to the Drug Use Disorder Identification Test (DUDIT) decreased more after NAC than after placebo, and the proportion of cocaine-positive urines at lab-visit 2 was lower in the NAC group. No NAC effects were found on craving. For cocaine use and craving, results from the lab data were generally similar to EMA results. NAC also showed some effects on cognitive control: improved inhibition assessed with the Stop Signal task in the lab, and decreased classic Stroop performance during EMA. There were no significant effects of number of completed WM-training sessions.CONCLUSIONS: Overall this study revealed mixed findings regarding the treatment of cocaine use disorders with NAC and WM-training. The effect of NAC on inhibition should be further investigated.

AB - INTRODUCTION: Effective treatment for cocaine use disorder should dampen hypersensitive cue-induced motivational processes and/or strengthen executive control. Using a randomized, double-blind, placebo-controlled intervention, the primary aim of this study was to investigate the effect of N-Acetylcysteine (NAC) and working memory (WM)-training to reduce cocaine use and craving and to improve inhibition assessed in the laboratory and during Ecological Momentary Assessment (EMA). The second aim was to examine correspondence between laboratory and EMA data.METHODS: Twenty-four of 38 cocaine-using men completed a 25-day intervention with 2400mg/day NAC or placebo and WM-training as well as two lab-visits assessing cocaine use, craving and inhibition (Stop Signal task). Additionally, cocaine use, craving and cognition (Stroop task) were assessed using EMA during treatment, with 26 participants completing 819 assessments.RESULTS: Cocaine problems according to the Drug Use Disorder Identification Test (DUDIT) decreased more after NAC than after placebo, and the proportion of cocaine-positive urines at lab-visit 2 was lower in the NAC group. No NAC effects were found on craving. For cocaine use and craving, results from the lab data were generally similar to EMA results. NAC also showed some effects on cognitive control: improved inhibition assessed with the Stop Signal task in the lab, and decreased classic Stroop performance during EMA. There were no significant effects of number of completed WM-training sessions.CONCLUSIONS: Overall this study revealed mixed findings regarding the treatment of cocaine use disorders with NAC and WM-training. The effect of NAC on inhibition should be further investigated.

KW - Cocaine

KW - Craving

KW - Inhibition

KW - N-acetylcysteine

KW - Working memory training

KW - Ecological momentary assessment

KW - RANDOMIZED CONTROLLED-TRIAL

KW - SUBSTANCE USE DISORDERS

KW - NICOTINE DEPENDENCE

KW - EXECUTIVE FUNCTIONS

KW - DRUG-USE

KW - QUESTIONNAIRE

KW - ADOLESCENTS

KW - ADDICTION

KW - ABSTINENCE

KW - REACTIVITY

U2 - 10.1016/j.addbeh.2017.11.044

DO - 10.1016/j.addbeh.2017.11.044

M3 - Article

C2 - 29241082

VL - 79

SP - 24

EP - 31

JO - Addictive Behaviors

JF - Addictive Behaviors

SN - 0306-4603

ER -