Generalization of Extinction Learning
| Status: | Recruiting |
|---|---|
| Conditions: | Anxiety, Healthy Studies, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology, Other |
| Healthy: | No |
| Age Range: | 18 - 55 |
| Updated: | 8/22/2018 |
| Start Date: | August 2013 |
| End Date: | June 2019 |
| Contact: | Michael Treanor, Ph.D. |
| Email: | mtreanor@psych.ucla.edu |
| Phone: | 310-825-5614 |
Cholinergic Decontextualization of Exposure Therapy for Anxiety
Fear, whether it occurs in humans suffering from an anxiety disorder or in experimental
models with rodents, is reduced by exposing the frightened organism to the fearful stimulus
in the absence of any negative consequences (i.e., extinction, or exposure therapy). However,
fear often renews when the feared stimulus is encountered in a context different from the
exposure context. In rats, the investigators found that interfering with the animal's ability
to process contexts during extinction by administering an anticholinergic drug prevented fear
renewal. This proposal will determine if the beneficial effect of this drug translates to
exposure therapy in socially anxious humans. To this end, 100 individuals with Social Phobia
who fear public speaking will undergo repeated sessions of exposure to public speaking,
within a virtual reality context. Participants will be randomized to either drug placebo,
.4mg/.01 mL Scopolamine, .5mg/.01 mL Scopolamine or .6mg/.01 mL Scopolamine, administered via
nasal drops, prior to each session of exposure therapy. One month after completion of
exposure therapy, context renewal will be tested by comparing physiological and subjective
responses to public speaking in the same virtual context as used during exposure therapy
versus a context different than the one used during exposure therapy. The goal is to identify
the dose of Scopolamine associated with the greatest reduction in context renewal. In
addition, a secondary analysis will attempt to identify those individuals who benefit most
from Scopolamine-augmentation of exposure therapy.
models with rodents, is reduced by exposing the frightened organism to the fearful stimulus
in the absence of any negative consequences (i.e., extinction, or exposure therapy). However,
fear often renews when the feared stimulus is encountered in a context different from the
exposure context. In rats, the investigators found that interfering with the animal's ability
to process contexts during extinction by administering an anticholinergic drug prevented fear
renewal. This proposal will determine if the beneficial effect of this drug translates to
exposure therapy in socially anxious humans. To this end, 100 individuals with Social Phobia
who fear public speaking will undergo repeated sessions of exposure to public speaking,
within a virtual reality context. Participants will be randomized to either drug placebo,
.4mg/.01 mL Scopolamine, .5mg/.01 mL Scopolamine or .6mg/.01 mL Scopolamine, administered via
nasal drops, prior to each session of exposure therapy. One month after completion of
exposure therapy, context renewal will be tested by comparing physiological and subjective
responses to public speaking in the same virtual context as used during exposure therapy
versus a context different than the one used during exposure therapy. The goal is to identify
the dose of Scopolamine associated with the greatest reduction in context renewal. In
addition, a secondary analysis will attempt to identify those individuals who benefit most
from Scopolamine-augmentation of exposure therapy.
Inclusion Criteria:
1. between the ages of 18 and 55,
2. fluent in English,
3. within normal body weight (BMI=18.5 to 24.9)
4. meet DSM-IV diagnostic criteria for Social Phobia and report a fear of public
speaking.
Exclusion Criteria:
1. participant report of a diagnosed medical or neurological disorder
2. prescription or over the counter medications that can interact with Scopolamine, such
as anticholinergic medications (e.g. belladonna alkaloids, antihistamines, meclizine,
tricyclic antidepressants, and muscle relaxants), cold medicines, cough suppressants.
Other drugs that will be reasons for exclusion include: antimuscarinics, nifedipine,
parasympathomimetics, amantadine, amoxapine, antacids, antidiarrheals, anxiolytics,
hypnotics, atomexetine, bupropion, cisapride, clozapine, cyclobenzaprine, digoxin,
disopyramide, dronabinol (THC), ethanol, maprotilline, memantine, metoclopramide,
nabilone, olanzapine, opiate agonists, orphenadrine, phenothiazines, potassium salts,
quinidine, sedating H1-blockers, topiramate, tricyclic antidepressants, erthyromycin,
ketoconazole, and tegaserod.
3. over the counter drugs or substances that may have a sedative effect (e.g. herbal
sedatives: ashwagandha, Duboisia hopwoodii, Prostanthera striatiflora, kava, mandrake,
valerian, cannabis, passiflora incarnate; Antihistamines: Diphenhydramine,
Dimenhydrinate, Doxylamine, Promethazine; Alcohol; Dextromethorphan)
4. individuals with urinary problems (e.g., BPH)
5. pregnant or nursing females (as the effect of Scop on fetuses is not known)
6. suicidality
7. delusions or hallucinations
8. history of substance dependence in last five years or substance abuse within the past
6 months
We found this trial at
1
site
Los Angeles, California 90095
310-825-4321
Principal Investigator: Michelle G. Craske, Ph.D
University of California at Los Angeles The University of California, Los Angeles (UCLA) is an...
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