A novel remote TSST procedure reliably increases stress reactivity in cannabis users: A pilot study.

The Trier Social Stress Test (TSST) is a standard laboratory stressor comprised of a speech and arithmetic tasks that reliably induces physiological and psychological stress. It is traditionally administered in a room where the participant takes part in the TSST in front of two "committee" members. However, due to the recent Coronavirus disease (COVID-19) pandemic, in-person research study procedures have been limited due to potential exposure risks. Since stress reactivity is associated with drug use and the TSST reliably increases stress reactivity among cannabis users, the present pilot study examined a "remote" version of the TSST using the cloud-based virtual video communications platform, Zoom, among cannabis-using individuals (N = 15). The use of a remote platform such as Zoom allowed the participant and the committee to interact in real time while limiting in-person contact. The primary aim of this study was to test the feasibility of a remote version of the TSST in producing an increase in subjective stress response, cannabis craving, and cardiovascular stress in individuals who use cannabis. Participants completed subjective effects questionnaires and had blood pressure (BP) assessed before (baseline) and at various time points after the TSST. Heart rate (HR) was continuously measured throughout the session. This remote version of the TSST significantly and robustly increased State Anxiety and Perceived Stress scores, BP, and HR compared to baseline. There was no effect of the remote TSST on cannabis craving. Overall, the remote version of the TSST appears to be an effective laboratory stressor for future stress reactivity studies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Safety and tolerability of progesterone treatment for women with cocaine use disorder: a pilot treatment trial.

Background: Problematic cocaine use remains a significant public health issue, particularly among women. However, no concerted efforts have been made to target a pharmacological treatment option for women with cocaine use disorder (CUD) despite preclinical, human laboratory, and a limited number of clinical studies demonstrating that progesterone can attenuate the effects of cocaine to a greater extent in women than men.Objectives: To evaluate the safety, tolerability, and preliminary efficacy of progesterone for treating women with CUD.Methods: A 10-week double-blind randomized treatment trial was conducted. Prior to randomization, participants were required to achieve cocaine abstinence (1 week) before assignment to progesterone (up to 400 mg/day) or placebo. The primary efficacy outcomes were days to relapse and cocaine abstinence during the last 3 weeks of the trial. The frequency of side effects was also assessed.Results: 227 women were assessed for eligibility. Twenty-five women entered treatment and 21 were randomized to progesterone (n = 11) or placebo (n = 10). The majority of women relapsed in less than 4 days with no differences between the two groups. Further, there were no significant differences between the progesterone and placebo groups in terms of cocaine abstinence during the last 3 weeks of the trial (27% and 10% respectively). The most commonly reported side effects were headache and fatigue, but no group differences were noted.Conclusions: Progesterone was well tolerated and safe and supports further study is in a larger sample to determine if exogenous progesterone is an effective treatment option for women with CUD.(ClinicalTrials.gov Identifier: NCT00632099).